Ventricular shunts and the prevalence of sensitization and clinically relevant allergy to latex in patients with spina bifida

Patients with spina bifida represent the highest-risk group for developing hypersensitivity to latex. Recognized risk factors for these patients are r epeated surgery and an atopic disposition. Our aim was to study the influen ce of a ventricular shunt as an independent risk factor. One hundred and si xty-one patients with spina bifida (median age 10 years) were investigated for the presence of a shunting device and the number, type and date of prev ious surgical interventions. Additionally, skin-prick tests and provocation tests were performed in order to classify sensitized and symptomatic latex -allergic individuals. Eighty-eight patients (54.7%) were sensitized; 55 (3 4.2%) were provocation-positive. Patients with a shunt system had undergone a significantly higher number of surgical procedures (p < 0.0001) and show ed significantly higher levels of immunoglobulin E (IgE)-antibodies to late x (p < 0.0001) than patients without a shunting device. The total number of operations correlated significantly with the level of IgE-antibodies to la tex in serum (p < 0.0001), whereas the number of shunt operations in patien ts with a ventricular shunt did not significantly correlate with the degree of sensitization, In conclusion, patients with spina bifida who have a ven tricular shunt are at particularly high risk because they undergo a signifi cantly higher number of operations than patients without a ventricular shun t. However, the ventricular shunt does not seem to be an independent risk f actor. Furthermore, this study emphasizes that individuals at high risk, su ch as patients with spina bifida, should be handled latex-free from the ver y beginning of life.