Role of cross-allergies to latex in clinical routine of anesthesia.
OBJECTIVE
To determine the applicability and reliability of a screening questionnaire to detect patients at high-risk of latex allergy; to assess the importance of other allergies such as profilin allergies (pollinosis) for presence of latex sensitization; and to determine the clinical effectiveness of preemptive avoidance of latex exposure in high-risk patients.


METHODS
Prospective, clinical trial.


METHODS
Operative theater of a university hospital.


METHODS
95 adult patients.


METHODS
Patients were preoperatively screened and classified for present latex allergy (high-risk and low-risk group) according to a specially designed screening questionnaire. Anesthesia and surgery in the high-risk group were performed strictly avoiding latex-containing materials. The low-risk group (other allergies including pollinosis) received routine treatment, without latex-avoidance. Effects of latex avoidance or exposure were evaluated by measuring specific IgE titers perioperatively.


RESULTS
According to the questionnaire, 45 patients at high risk were defined. Validity of classification of high-risk patients is supported by significantly higher total IgE and latex and grass profilin specific IgE compared to the low-risk group. There were no significant differences in other profilin-specific IgEs. In one case of severe anaphylactic reaction a drop of latex-specific IgE during surgery could be observed.


CONCLUSIONS
The questionnaire allowed the identification of most patients at high risk for latex allergy. In isolated pollinosis no changes in any specific IgE levels were detectable. Strict avoidance of perioperative latex exposure in high-risk patients increases safety during anesthesia and surgery.
Haeberle
Helene A
HA
Department of Anesthesiology, Clinical University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany. helene.haeberle@uni-tuebingen.de
Lupic
Daniela
D
Midoro-Horiuti
Terumi
T
Kiefer
Ralph T
RT
Schroeder
Torsten H
TH
Unertl
Klaus
K
Dieterich
Hans Juergen
HJ
D000595:Amino Acid Sequence; D000758:Anesthesia; D003429:Cross Reactions; D018876:Environmental Illness / Q000175:diagnosis; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis / Q000096:biosynthesis; D007840:Latex / Q000737:chemistry; D020315:Latex Hypersensitivity / Q000175:diagnosis* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D006109:Poaceae / Q000737:chemistry; D011058:Pollen / Q000737:chemistry / Q000276:immunology; D011300:Preoperative Care; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment; D011795:Surveys and Questionnaires
D007840:Latex; D007073:Immunoglobulin E