title: Longitudinal study on specific IgE against natural rubber latex, banana and kiwi in patients with spina bifida.
abstract: OBJECTIVE
  Up to 2 out of 3 spina bifida (sb) patients with natural rubber latex (NRL) antibodies (ab) have crossreacting IgE-ab against tropical fruit, due to structural homologies between several NRL antigens and allergenic fruit proteins. It is essential to investigate whether the patients were first sensitized against NRL or fruit, to give recommendations for an evidence-based prophylaxis.
  
  
  METHODS
  We investigated sera of 96 sb patients for specific IgE ab against NRL, banana and kiwi as examples for crossreacting fruit by FEIA (ImmunoCAP System, Phadia). These tests were repeated up to 3 times (mean after 2 years, maximum after 7 years).
  
  
  RESULTS
  In the first testing only 2 of 50 NRL-IgE negative patients (4%) had ab against banana or kiwi. 4 of the 46 NRL-IgE positive patients (8%) showed ab against banana (2) or kiwi (2), 3 (7%) against both fruit. Symptoms of fruit allergy were presented by 3 patients, all symptomatic patients had high levels of specific fruit-ab. In the follow-up study 2 patients with low sensitization against NRL lost their NRL ab and their fruit ab, another 2 only the fruit ab, whereas 4 NRL-sensitized patients newly developed ab against banana and 1 against kiwi. Only 2 patients developed ab against fruit without being sensitized against NRL. 7 out of 10 patients with banana and kiwi ab were atopics.
  
  
  CONCLUSIONS
  In most cases the sensitization against fruit follows the NRL sensitization. There is no need to recommend sb patients without NRL sensitization to primarily avoid tropical fruit.
authors.affiliation: Kliniken der Stadt Köln gGmbH, Kinderkrankenhaus, Klinik für Kinder- und Jugendmedizin, Köln, Germany. CremerR@kliniken-koeln.de
authors.forename: R
authors.initials: R
authors.lastname: Cremer
authors.forename: O
authors.initials: O
authors.lastname: Mennicken
mesh_terms: D029042:Actinidia / Q000276:immunology*; D000918:Antibody Specificity / Q000276:immunology*; D003429:Cross Reactions / Q000276:immunology; D054242:Emigrants and Immigrants; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000276:immunology* / Q000517:prevention & control; D005858:Germany; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D020315:Latex Hypersensitivity / Q000175:diagnosis / Q000276:immunology* / Q000517:prevention & control; D008137:Longitudinal Studies; D008297:Male; D028521:Musa / Q000276:immunology*; D012408:Rubber; D016135:Spinal Dysraphism / Q000276:immunology* / Q000601:surgery; D040681:Structural Homology, Protein; D014421:Turkey / Q000208:ethnology
chemical_list: D007073:Immunoglobulin E; D012408:Rubber