LATEX ANAPHYLAXIS

In the past decade, immediate hypersensitivity to latex has been accep ted as a serious problem. The proteins that are present in natural rub ber are considered to be the responsible antigens, and the hypersensit ivity responses induced include contact and generalized urticaria, ang ioedema, rhinitis, conjunctivitis, bronchospasm, life threatening anap hylaxis and death. So far, children with spina bifida or severe urogen ital defects, health care workers, and rubber industry employees appea r to be at greater risk than the general population. Since 1991 severa l reports and cross-reactivity studies have demonstrated an associatio n between latex allergy and allergy to certain fruits, especially bana na, avocado and kiwi. Because our knowledge of the major allergens is still incomplete, standardised in vitro and in vivo tests are not yet readily available. Therefore, the clinician should rely on a medical h istory, physical examination, and reliable serological tests to confir m diagnosis of latex anaphylaxis. Because of possible systemic reactio ns to skin prick testing and provocation tests, these methods should b e restricted to patients with a compelling history and an-inconclusive serologic test result. Preventive measures are the key to succesful a nd safe management of patients with latex anaphylaxis.