Dreyfus David H, Fraser Barbara, Randolph Christopher C
Waterbury Hospital, Yale School of Medicine, Waterbury, CT, USA.
Conn Med. 2004 Apr;68(4):217-22.
We describe a representative patient diagnosed with anaphylaxis to latex occurring during elective surgery in the absence of any previous risk factors for latex allergy. Latex allergy was identified by skin prick testing and confirmed by serological diagnosis testing. We review our experience screening patients for latex allergy in Connecticut over the period 1995-present. Patients without known risk factors for latex allergy in a highly atopic population had a low rate (approximately 1%) of positive skin tests to latex when screened using an allergenic extract characterized for latex allergen by serological diagnosis at 200-500 AU/ml. Our experience suggests that skin prick test screening with serological diagnosis standardized latex extracts can be used to rapidly screen and identify individuals with latex allergy although the cost-effectiveness, sensitivity and safety of screening remains to be determined. Clinicians should consider the diagnosis of latex allergy in all cases of anaphylaxis without identified causes, even in patients without identified risk factors for latex allergy.
我们描述了一名有代表性的患者,该患者在择期手术期间被诊断为对乳胶过敏,而此前并无任何乳胶过敏的风险因素。通过皮肤点刺试验确定了乳胶过敏,并通过血清学诊断试验得以证实。我们回顾了1995年至今在康涅狄格州对患者进行乳胶过敏筛查的经验。在高度特应性人群中,没有已知乳胶过敏风险因素的患者,当使用通过血清学诊断确定为200 - 500 AU/ml乳胶过敏原的变应原提取物进行筛查时,对乳胶皮肤试验呈阳性的比例较低(约1%)。我们的经验表明,使用血清学诊断标准化乳胶提取物进行皮肤点刺试验筛查,可用于快速筛查和识别乳胶过敏个体,尽管筛查的成本效益、敏感性和安全性仍有待确定。临床医生应在所有无明确病因的过敏反应病例中考虑乳胶过敏的诊断,即使是在没有明确乳胶过敏风险因素的患者中。