Kanny G, Prestat F, Moneret-Vautrin D A
Service de Médecine D, Centre Hospitalier Universitaire de Nancy, Nancy-Vandoeuvre, France.
Allerg Immunol (Paris). 1992 Nov;24(9):329-32.
The authors report the case of a female cook who develops contact urticaria associated with rhinitis and asthma-type dyspnea when using rubber gloves in the course of her work. Allergy to latex was confirmed by a PRICK-test with latex, the presence of specific IgE in the serum, and the onset of contact urticaria after putting on gloves. A latex glove was rinsed with 10 cc of distilled water and the resulting solution, used as a spray, brought on a bronchospasm in the first two minutes. This bronchial provocation test proves that latex can cause asthma-type dyspnea when work involves contact with the substance. The speed of onset and intensity of the respiratory symptoms observed show that such a provocation test must be carried out with extreme care in patients with a marked sensitivity to latex. The future lies in the possibility of easily standardizing the latex protein concentration in order to be able to administer progressive doses without any systemic risk. This case draws attention to the probably underestimated possibility of latex-induced asthma in all subjects who are brought into repeated contact with latex, whatever their profession.
作者报告了一名女性厨师的病例,她在工作过程中使用橡胶手套时出现了与鼻炎和哮喘样呼吸困难相关的接触性荨麻疹。通过用乳胶进行点刺试验、血清中特异性IgE的存在以及戴上手套后出现接触性荨麻疹,证实了对乳胶过敏。用10毫升蒸馏水冲洗一只乳胶手套,将所得溶液用作喷雾剂,在头两分钟内引发了支气管痉挛。这项支气管激发试验证明,当工作涉及接触该物质时,乳胶可导致哮喘样呼吸困难。观察到的呼吸道症状的发作速度和强度表明,对于对乳胶高度敏感的患者,必须极其谨慎地进行这种激发试验。未来在于有可能轻松地标准化乳胶蛋白浓度,以便能够给予递增剂量而无任何全身风险。该病例提醒人们注意,在所有反复接触乳胶的受试者中,无论其职业如何,乳胶诱发哮喘的可能性可能被低估了。