Latex allergy in subjects who had undergone multiple surgical procedures for bladder exstrophy: relationship with clinical intervention and atopic diseases

Objective To evaluate the prevalence of latex sensitization in a group of p atients with bladder exstrophy, and to determine the role of associated ris k factors, e.g. atopy, and the number and duration of surgical and anaesthe tic procedures. Patients and methods The study comprised 17 patients (15 children and two y oung adults) affected by bladder exstrophy who had undergone multiple surgi cal procedures. Skin-prick tests and specific immunoglobulin-E (IgE) assays against latex, food allergens cross-reacting with latex and inhalant aller gens were carried out. Results Twelve patients showed latex sensitization and five showed symptoms related to latex exposure, the most common of which was contact urticaria (four of the symptomatic patients). Intraoperative anaphylactic reaction ha d led to life-threatening events in only one child. Latex-specific IgE dete rmined both by the prick test and assay was positive in all those with symp toms. Specific IgEs against inhalant allergens and foods were present in fo ur of five symptomatic patients. In the seven sensitized patients with no c linical symptoms, the assay was positive in all, while the skin-prick test was positive only in four; specific IgEs against inhalant allergens were pr esent in three of the seven. In the five patients not allergic and not late x-sensitized, only one showed allergic sensitization against grass pollen a nd mite allergen. None of the children without latex antibodies had symptom s of latex allergy. Symptomatic patients had a undergone significantly more hours of surgery, more cystography and had used intermittent catheterizati on for longer than those with no symptoms. Conclusion A third of patients with bladder exstrophy showed latex symptoms and another third had latex sensitization. Multiple surgical procedures an d atopy play a major role in the development of latex hypersensitivity.