Nawa Y, Imaizumi H, Masuda Y, Hazama K, Sato M, Namiki A, Asai Y
Department of Anesthesiology, School of Medicine, Sapporo Medical University.
Masui. 2000 Sep;49(9):1027-9.
A 15 year old female with uterus bicornis bicollis was admitted for operation. She had a history of atopic dermatitis and allergy to buckwheat, raw egg and latex. Two months previously she had developed whole body flushing during dental treatment, and latex glove used by the dentist had been suspected as the cause. Prior to the operation she underwent internal examination and intrauterine echogram in which a latex glove was carelessly used by another gynecologist who had not confirmed her past history. After 30 minutes, dyspnea and urticaria without itching, appeared suddenly. Blood pressure decreased to 80/50 mmHg and heart rate increased to 120 beats.min-1. She was then transferred to our ICU. Methylprednisolone was administered intravenously for dyspnea and circulatory collapse. After 3 hours, the patient made an uneventful recovery. The increased plasma latex protein-specific IgE levels confirmed anaphylaxis to latex. The increasing incidence of potentially life-threatening allergic reactions to latex has caused mounting concern over recent years. We may suspect latex allergy when an anaphylaxic reaction or shock of unknown origin occurs. In hospitals, latex free products must be prepared for use with latex allergic patients and for protection of medical staff with this allergy.
一名15岁双子宫双宫颈女性入院接受手术。她有特应性皮炎病史,对荞麦、生鸡蛋和乳胶过敏。两个月前,她在牙科治疗期间出现全身潮红,怀疑是牙医使用的乳胶手套所致。手术前,她接受了内诊和子宫内超声检查,在此过程中,另一位未询问其既往病史的妇科医生不小心使用了乳胶手套。30分钟后,她突然出现无瘙痒的呼吸困难和荨麻疹。血压降至80/50 mmHg,心率增至120次/分钟。随后她被转入我们的重症监护病房。静脉注射甲基强的松龙以治疗呼吸困难和循环衰竭。3小时后,患者顺利康复。血浆乳胶蛋白特异性IgE水平升高证实对乳胶过敏。近年来,对乳胶潜在危及生命的过敏反应发生率不断上升,引起了越来越多的关注。当发生不明原因的过敏反应或休克时,我们可能会怀疑乳胶过敏。在医院,必须准备无乳胶产品,供乳胶过敏患者使用,并保护有此过敏症的医护人员。