title: Low prevalence of latex allergy in children with spinal dysraphism in non-latex-free environment.
abstract: BACKGROUND
  Studies in the past have shown that children with spinal dysraphism have highly prevalent latex allergy. These children have a spectrum of congenital spinal anomalies, caused by defects in neural tube closure, with an incidence of 1 in 1000 births. Proposed risk factors for latex allergy include multiple surgeries since birth, including an insertion of a ventriculoperitoneal shunt, elevated IgE titers, repeat multiple catheterizations, and atopy. In the 1990 s, studies published in the United States and Europe showed a latex allergy prevalence of over 70% in these patients. On the other hand, studies published years later in other countries showed a declining prevalence of no more than 17%.
  
  
  OBJECTIVE
  Our goal was to prospectively assess the prevalence of latex allergy in children with spinal dysraphism in our non-latex free environment center compared with a control group.
  
  
  METHODS
  The study group included 58 children with spinal dysraphism attending our center between 2010 and 2013. Findings were compared to 65 children referred for evaluation of allergic diseases. The parents completed questionnaires assessing personal and familial history of allergic diseases. All children were tested for blood latex IgE-specific antibodies (IMMULITE 2000).
  
  
  RESULTS
  The mean age was 120.9 (67.6) months in the study group and 129.5 (68.5) months in the control group (p = 0.27). The corresponding median number of surgical procedures was 2 (range 0-10) and 0 (range 0-4), and mean duration of clean intermittent catheterization was 52 (72.2) months in the study group. Positive IgE antibodies and clinical allergic reactions were low with very similar prevalence in both groups (Figure).
  
  
  CONCLUSIONS
  Our results show considerable lower latex allergy and sensitization than studies published in the United States and Europe in the past, despite the fact that our center utilizes minimal avoidance measures for latex allergy. Study limitations include the relatively small number of patients in our single-center study. Moreover, our control group could not include normal volunteering healthy children due to institutional review board refusal.
  
  
  CONCLUSIONS
  Children with spinal dysraphism in our center have a low prevalence of latex allergy. Possible explanations include low latex protein content gloves and catheters used worldwide, including our center, lower number of surgeries, or a disease associated propensity for latex sensitization with a geographically variable genetic association. More studies are needed to validate our conclusion that using minimal avoidance measures, without maintaining a strict latex free environment, seems sufficient to prevent clinical latex allergy, at least in the Mediterranean region.
authors.affiliation: Urology Unit, Schneider Children's Medical Center of Israel, and Sackler School of Medicine, Tel Aviv University, Israel. Electronic address: Gohanan@gmail.com.
authors.forename: Hanan
authors.initials: H
authors.lastname: Goldberg
authors.affiliation: Urology Unit, Schneider Children's Medical Center of Israel, and Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Shachar
authors.initials: S
authors.lastname: Aharony
authors.affiliation: Kipper Institute of Immunology & Allergy, Schneider Children's Medical Center of Israel, and Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Levy
authors.affiliation: Urology Unit, Schneider Children's Medical Center of Israel, and Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Bezalel
authors.initials: B
authors.lastname: Sivan
authors.affiliation: Urology Unit, Schneider Children's Medical Center of Israel, and Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Jack
authors.initials: J
authors.lastname: Baniel
authors.affiliation: Urology Unit, Schneider Children's Medical Center of Israel, and Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Ben Meir
mesh_terms: D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D007840:Latex; D020315:Latex Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D019635:Neurosurgical Procedures; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D016135:Spinal Dysraphism / Q000601:surgery*
chemical_list: D007840:Latex
keywords: Atopy; IgE antibodies; Latex allergy; Latex sensitization; Spinal dysraphism