Latex hypersensitivity in spinal cord injured adult patients

Latex hypersensitivity is a major cause of anaphylaxis during anaesthesia. Patients with spina bifida, health care or rubber industry workers have bee n considered at risk for latex sensitization. By analogy, the existence of other at-risk subsets of patients with latex exposure due to frequent surgi cal procedures has been suggested. The aim of this study was to evaluate the prevalence of latex sensitization in a cohort of adult patients with spinal cord injury and repeated latex e xposure. Forty-two adult patients with spinal cord injury were studied and retrospec tively compared to a group of 30 children with spina bifida evaluated using a similar protocol. Patients were administered a questionnaire concerning history of latex hype rsensitivity, atopy, and surgical procedures. Latex sensitivity was investi gated by skin prick-tests and latex-specific IgE assay. The search for atop y? was based on in vivo and in vitro tests against a panel of environmental allergens. No chronic spinal cord injured patient had a history of latex allergy. When compared with spina bifida, the number of surgical procedures was not stat istically different. Although not significantly different, the prevalence o f atopy was higher in spina bifida patients. The high level of latex sensit ization in spina bifida patients contrasted sharply with the absence of sen sitization observed on both skin and in vitro tests in patients with spinal cord injury (P < 0.0001). This study confirms that adult patients with chronic neurologic defects res ulting from spinal cord injury exhibit a low risk of latex sensitization. T hese results suggest that considering adult patients with repeated surgical procedures as a group at risk for latex sensitization because of a high de gree of latex exposure should be re-examined.