Dehlink E, Prandstetter C, Eiwegger T, Putschögl B, Urbanek R, Szépfalusi Z
Department of Pediatrics, Division of General Pediatrics, Medical University of Vienna, Vienna, Austria.
Allergy. 2004 Jul;59(7):734-8. doi: 10.1111/j.1398-9995.2004.00503.x.
Type-I-allergy to natural rubber latex (NRL) has been shown to be more prevalent among certain groups of patients. Children suffering from chronic renal failure (CRF) could be a suspected risk group because of their intense exposure to latex through catheters, gloves and anesthetic equipment during frequent hospitalizations from early life on. We investigated the prevalence of latex-sensitization among this group of patients and sought to identify risk factors.
Ninety-three patients (mean age 10.5 years) suffering from CRF were assessed by questionnaire-based history (details on renal disease, number and kind of surgical procedures, family and personal history of atopic diseases, allergic reactions to NRL, and the use of pacifiers) and by measurement of total and latex-specific serum immunoglobulin (Ig)E.
Ten of 93 (10.8%) patients showed elevated latex-specific IgE-levels. One of 10 patients reported clinical symptoms to latex-allergen, but no allergic reactions to NRL during medical care were reported. Sensitized patients were significantly more likely to be atopic, reflected by a positive history of other allergies as well as elevated total serum IgE-levels, and had a significantly higher number of urogenital surgeries (P = 0.02 in all cases, Fisher's exact and Wilcoxon test, respectively).
This study demonstrates that children with CRF are at increased risk of latex-hypersensitivity. Significant associations with atopy and repeated surgeries were observed. Larger studies are required to elucidate whether these children are also at increased risk of anaphylaxis and therefore deserve preventive measures.
I型天然橡胶乳胶(NRL)过敏在某些患者群体中更为普遍。患有慢性肾衰竭(CRF)的儿童可能是疑似风险群体,因为从幼年起,他们在频繁住院期间通过导管、手套和麻醉设备大量接触乳胶。我们调查了该患者群体中乳胶致敏的患病率,并试图确定风险因素。
通过基于问卷的病史(关于肾脏疾病、手术程序的数量和类型、特应性疾病的家族和个人病史、对NRL的过敏反应以及安抚奶嘴的使用情况)以及测量总血清免疫球蛋白(Ig)E和乳胶特异性IgE对93例CRF患者(平均年龄10.5岁)进行评估。
93例患者中有10例(10.8%)乳胶特异性IgE水平升高。10例患者中有1例报告了对乳胶过敏原的临床症状,但在医疗护理期间未报告对NRL的过敏反应。致敏患者更有可能患有特应性疾病,表现为有其他过敏的阳性病史以及总血清IgE水平升高,并且泌尿生殖系统手术的次数明显更多(在所有情况下P = 0.02,分别采用Fisher精确检验和Wilcoxon检验)。
本研究表明,CRF儿童乳胶过敏的风险增加。观察到与特应性疾病和反复手术有显著关联。需要进行更大规模的研究来阐明这些儿童是否也有更高的过敏反应风险,因此是否值得采取预防措施。