NATURAL-RUBBER LATEX ALLERGY IN CHILDREN WHO HAD NOT UNDERGONE SURGERY AND CHILDREN WHO HAD UNDERGONE MULTIPLE OPERATIONS

Background: Children with spina bifida and other children requiring mu ltiple surgical procedures represent a well-known risk group for natur al rubber latex allergy. Children not undergoing surgery can also be s ensitized, but findings in this group of children with latex allergy h ave not been thoroughly examined. Objectives: We sought to examine the frequency of latex allergy in a large group of children admitted for inhalant or food allergy testing for the purpose of collecting informa tion on a series of children with latex allergy and comparing the symp toms and findings between those not undergoing surgery and those under going multiple operations. Methods: Children admitted to the allergy l aboratory of Tampere University Hospital were screened by skin prick t ests (SPTs) with latex glove extract, All children with allergy as det ermined by the screening or admitted because of suspected latex allerg y were reexamined from 1995 to 1996. For a definite diagnosis of latex allergy, positive SPT, latex RAST, and latex glove use test results w ere required. Results: From 1992 to 1995, a total of 3269 children wer e skin prick tested with latex glove extract, and 55 (1.7%) had a posi tive response, On reexamination, 37 (1.1%) children had positive respo nses to SPTs, and 33 (1.0%) were confirmed to have latex allergy by me ans of RASTs and latex glove use tests. Since 1988, we have identified a total of 30 children with latex allergy who had not undergone surge ry and 12 who underwent multiple operations. The clinical histories we re similar in both groups; the mean ages at diagnosis were 5.7 and 8.1 years, and the frequency of atopy was 97% and 83%, respectively. Symp toms had occurred in 63% of the children who had not undergone surgery and in 75% of the children who underwent multiple operations. Contact urticaria was the most frequent symptom, and only one child had intra operative anaphylaxis. Balloons, followed by gloves, were the most com mon latex products causing symptoms. The children with latex allergy w ho had not undergone surgery and those who underwent multiple operatio ns showed no significant differences in SPT responses to commercial la tex allergen extract or in specific IgE levels. Conclusions: The preva lence of latex allergy among children admitted for inhalent or food al lergy testing was 1%. Although multiple operations at an early age are a well-known risk factor for latex allergy, the majority of children with latex allergy identified at screening or admitted because of susp icion of latex allergy belonged to the group of children who had not u ndergone surgery. One third of all the children studied were free of s ymptoms, indicating that screening with SPTs can be a valuable tool fo r detecting occult latex allergy in children.