LATEX ALLERGY IN NON-SPINA BIFIDA PATIENTS - UNFAMILIAR INTRAOPERATIVE ANAPHYLAXIS

Background: The medical literature has described the prevalence of lat ex allergy in the spina bifida population and its implications for sur gical intervention. We report three cases of severe and unexpected int ra-operative anaphylaxis secondary to latex exposure in non-spina bifi da patients. Methods: A retrospective review of case notes identified three non-spina bifida patients who suffered intra-operative anaphylax is due to latex allergy. Personal and telephone interview and patient chart review was performed to detail a past history of multiple latex exposure, atopy, the anaphylaxis event and the postoperative outcome. Results: Three non-spina bifida patients are described. One suffered a cardiopulmonary arrest, the remaining two patients had severe vascula r hypotension and airway resistance that was only relieved after admin istration of vasoconstrictors and bronchodilators. Postoperatively, al l three tested strongly positive to latex allergen testing. Each patie nt had a history of multiple surgical latex exposure and specific alle rgies or allergic-type symptoms pre-operatively.Conclusion: We believe that the predictors of a severe allergic reaction to latex with surgi cal exposure in non-spina bifida patients may be similar to those pred ictors known in the spina bifida population. Identification of such at -risk patients will reduce the risk of significant intra-operative mor bidity and possible mortality by the introduction of a latex-free oper ating environment.