title: Recurrent anaphylaxis due to unrecognized latex hypersensitivity in two healthcare professionals.
abstract: BACKGROUND
  Anaphylaxis is a potentially fatal immediate-type reaction and intense effort may be required to identify the allergen responsible. In some cases, a "hidden" allergen may be responsible that is not apparent in spite of careful clinical assessment.
  
  
  OBJECTIVE
  This report describes the assessment of two cases of anaphylaxis in which a search for an allergen was initially not conclusive and the diagnosis of idiopathic anaphylaxis was considered.
  
  
  METHODS
  Two patients were evaluated by various physicians for anaphylaxis with no clear indication of a responsible allergen. Persistence in evaluation led to the identification of the allergen responsible.
  
  
  RESULTS
  In two health care workers latex was identified as the "hidden" cause of anaphylaxis. This allergen had not been considered in either case in initial evaluations. Neither patient has had a recurrence of anaphylaxis since latex was identified as the cause of anaphylaxis.
  
  
  CONCLUSIONS
  Although latex is widely recognized as a cause of anaphylaxis, it can still be unrecognized in some cases of recurrent anaphylaxis. Latex must be considered as a "hidden" cause of anaphylaxis, particularly in health care workers.
authors.affiliation: Department of Medicine, Northwestern University Medical School, Chicago, Illinois, USA.
authors.forename: D
authors.initials: D
authors.lastname: Masood
authors.forename: J E
authors.initials: JE
authors.lastname: Brown
authors.forename: R
authors.initials: R
authors.lastname: Patterson
authors.forename: P A
authors.initials: PA
authors.lastname: Greenberger
authors.forename: L
authors.initials: L
authors.lastname: Berkowitz
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced*; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000209:etiology*; D005260:Female; D005932:Gloves, Surgical; D006281:Health Occupations; D006801:Humans; D007840:Latex / Q000009:adverse effects*; D012008:Recurrence; D012882:Skin Tests
chemical_list: D007840:Latex