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Allergy to latex: know the diversity of symptoms to avoid it

Allergy to latex: know the diversity of symptoms to avoid it

Latex allergy is defined as an immunological reaction against natural rubber latex particles after prior sensitization. Therefore, there must be previous contact for the reaction to occur.

According to data from the world literature, it is estimated that the prevalence of latex allergy in the population is less than 1%. In populations at risk, such as health professionals exposed to latex gloves, patients with spina bifida and individuals who underwent surgery early and repeatedly, this prevalence may reach 36% to 72%, respectively.

The patient should have a treatment plan. action for emergency situations, in addition to being clearly oriented to avoid latex.

The natural latex used in the industry is almost exclusively extracted from a plant called Hevea brasilienses. Latex is a protein compound, so far 14 allergens have been identified. There are three risk groups for the development of latex allergy:

  • Adults working in areas with high exposure of latex proteins. Examples: dentists, surgeons, anesthetists, professionals working in critical care areas. These professionals change glove many times a day, increasing the risk of sensitization and development of the allergic reaction. Rubber industry workers also show increased prevalence of latex allergy
  • Patients who require surgical manipulations. such as neuropaths and nephropathies. Patients with atopic disease (asthma, allergic rhinitis, atopic dermatitis and food allergy / latex-fruit syndrome).
  • The most common reaction common to latex-containing products, especially glove users, is dryness and irritation in the area of ​​contact, called "Irritative dermatitis." It is a non-immune reaction caused by repetitive washing of hands with soaps or detergents, and the talc of glove or latex powder can become the gateway for the sensitization of latex. Immunological reactions to natural rubber are type I (IgE-mediated) or late (lymphocyte-mediated) type IV, related to vulcanization accelerators (tiurans, carbamates, mercaptomix) and antioxidants (hydroquinone and paraphenylenediamine) added to the latex.

Prior sensitization is required for Type I reaction to occur, ie the patient must present IgE class specific antibody to at least 1 of the latex antigens. Sensitization occurs when there is contact with latex-containing material, especially gloves or even inhalation of aerosolized particles.

The patient will experience immediate symptoms after contact with latex-containing products such as allergic conjunctivitis, allergic rhinitis, or asthma. It may present contact itching urticaria and plaque formation with redness in place. The reactions may be mild or even life threatening, such as anaphylaxis. More severe reactions with extensive urticaria, severe asthma attacks, hypotension, and shock are related to latex contact through the parenteral route or through the mucous membranes and should receive rapid response.

For the type IV reaction to occur sensitization is required and symptoms begin 48 to 72 hours after contact with the allergen. The reaction happens due to the addition of antioxidants and accelerators in the production of latex. Most patients have contact dermatitis in the hands related to the use of gloves (may present redness, vesicles, crusting, peeling and itching). Reaction with condoms can happen too, in this case in the place of contact with it can be itching, redness, peeling. Alternative to this issue is the use of latex-free condoms.

There is also Latex-fruit syndrome, characterized by the association of allergy symptoms after contact with latex and some foods of plant origin. Latex and some foods show a cross reaction. The antibody against one allergen reacts to another allergen of different origin. Allergens with cross-reaction have similarity of 70%. The most common food related to: Kiwi, passion fruit, avocado, cassava, potato and banana.

Diagnosis

The diagnosis of latex allergy is based on detailed medical history and some diagnostic tests. For the detection of type I reaction, it may be done:

Immediate or puncture hypersensitivity skin test

  • Specific serum IgE dosage against latex (Immunocap)
  • For type IV reaction detection, it may be done o Patch allergy test.

There are also new tests, such as ImmunoCAP ISAC. When no test is confirmed, a skin test or glove test can be performed in an environment prepared to respond to a possible anaphylactic reaction.

Treatment

The patient should have a plan of action for emergency situations, in addition to being clearly oriented to avoid latex. Latex gloves can be replaced with nitrile or silicone gloves, as well as latex-free condoms. In case of surgery give preference to latex-free surgical rooms. Stay alert for contact with party balloons and latex-containing products in dentists and doctors.


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