THE PREVALENCE OF LATEX ALLERGY IN CHILDREN SEEN IN A UNIVERSITY HOSPITAL ALLERGY CLINIC

Natural rubber latex allergy is responsible for a wide spectrum of cli nical symptoms, ranging from rhinoconjunctivitis to severe anaphylaxis , in both adults and children. An association between allergy to latex and allergy to various fruits has been reported. This study investiga ted the prevalence and clinical significance of latex sensitization in children seen in a university hospital allergy clinic A total of 453 consecutive children were screened in a 7-month period. A detailed cli nical history with particular attention to the past surgical history a nd the eventual presence of latex- or food-induced allergic symptoms w as obtained. Skin prick tests (SPT) for the more important inhalant al lergens and foods were performed on all children. In patients with pos itive latex SIT latex challenge and additional SPT for some fresh food s (avocado, pineapple, apricot, grape, banana, pear, apple, orange, al mond, and chestnut) were also performed. RAST for the same food antige ns, as well as patch test with latex and a standard battery of contact allergens, was also done. Of 326 atopic children, 10 (3%) presented p ositive skin test to latex, but only five (1.5%) also had a positive c linical history to latex exposure. Latex challenge was positive in 3/9 positive-latex-SPT children. None of the nonatopic children had posit ive skin test to latex or symptoms to latex exposure. A history of pre vious surgery was found in 5/10 positive-latex-SPT children, in 63/316 negative-latex-SPT atopic children (P<0.05), and in 23/127 nonatopic children. RAST to latex was positive in 5/10 positive-latex-SPT childr en. Associated fruit-specific IgE (SPT and/or RAST) were found in all latex-symptomatic children and in 2/5 latex-asymptomatic children. App le, kiwi, and chestnut were the most common SPT-positive foods Only on e patient with clinical allergy to latex and positive skin tests to fr uits had a history of clinical symptoms after ingestion of kiwi and or ange. The natural history of the positive-latex-SPT children without c linical reactions to latex exposure and the clinical significance of t he association of latex and fruit sensitivity require further studies.