SKIN AND SEROLOGIC TESTING IN THE DIAGNOSIS OF LATEX ALLERGY

Background: Later hypersensitivity is associated with occupational all ergy, contact urticaria, rhinitis, asthma, and anaphylaxis. However, s tandardized sensitive and specific latex extract for skin prick or ser ologic testing is not available in the United States. Methods: We inve stigated the reliability of two latex extracts in 118 consecutive skin tests in patients with spina bifida, health care workers, and other p atients with symptoms of latex allergy, and 10 control subjects. Resul ts: Forty-two of 86 patients with spina bifida, 11 of 15 health care w orkers with symptoms of later allergy, 6 of 7 patients with symptoms o f latex allergy, and 0 of 10 control subjects had demonstrable immedia te wheal and flare responses to latex prick testing. In addition, 95 p atients and 10 control subjects were tested concurrently for latex-spe cific IgE by ELISA. Of 55 patients with positive skin prick test resul ts, 48 were reactive as determined by ELISA for IgE-specific latex ant ibody (sensitivity = 87%). Latex ELISA titers were significantly highe r in patients with positive skin prick test results with a history of anaphylaxis to latex and in individuals without symptoms of latex alle rgy who had positive skin prick test results when compared with patien ts with negative skin prick test results. During the skin test procedu re, nine patients had adverse reactions, including anaphylactic reacti ons in four. Conclusions: Skin prick and serum testing are reliable me thods of diagnosing latex allergy. Serologic evaluation may be more de sirable until allergen standardization is available.