LATEX ALLERGY MANIFESTED IN UROLOGICAL SURGERY AND CARE OF ADULT SPINAL-CORD INJURED PATIENTS

This report exemplifies the cases of two male and one female spinal co rd injury (SCI) patients with latex allergy, two of whom had life thre atening episodes of intraoperative cardiovascular collapse. The three patients were extensively exposed to latex products as a result of uri nary management programs, and two developed marked hypotension immedia tely upon abdominal exploration during reconstructive urological surge ry. The third case represents the development in a male of latex aller gy to over 12 types of latex condoms manifest as penile dermatitis. In each of these cases, allergy and immunology consultation confirmed th e latex allergy. The diagnosis of latex allergy was established using both Radioallergosorbert (RAST) testing and a skin test to the latex a ntigen. The two patients who experienced intraoperative cardiovascular collapse required resuscitation with intravenous fluids, epinephrine, and antihistamines. Because each episode of hypotension occurred duri ng bowel manipulation with latex gloves, they were suspected of induci ng anaphylaxis. In the third patient, latex allergy was suspected afte r the immediate resolution of allergic symptoms upon replacing latex c ondom catheters with those made of silicone. This is the first report of a life-threatening reaction to latex allergy in the SCI population. Measures instituted to prevent further latex-associated morbidity inc luded the use of medical alert bracelets, self-administration epinephr ine injection kits, and nonlatex appliances, including gloves, condoms , and urethral catheters. It is recommended that precautions against t he development of anaphylaxis be undertaken in SCI patients with chron ic exposure to latex-containing products. (C) 1994 by the American Con gress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation