Marcos C, Lázaro M, Fraj J, Quirce S, de la Hoz B, Fernández-Rivas M, Losada E
Servicio de Alergia, Hospital Ramón y Cajal, Madrid, Spain.
Ann Allergy. 1991 Sep;67(3):319-23.
Since 1979 several reports of contact urticaria due to natural latex have been well documented. Recent case reports suggest that rhinitis and asthma may also be due to rubber exposure. We describe an operating room nurse who was exposed at work to natural rubber (latex) due to the use of latex surgical gloves. After 25 years, she developed contact urticaria, rhinoconjunctivitis and acute asthma following the handling of rubber gloves for surgical purposes. She was symptom-free when on vacation. Skin prick testing demonstrated an immediate skin reaction to latex. Rub testing with surgical gloves was positive. Specific IgE antibodies to latex were found by indirect ELISA. Specific bronchial challenge with latex extract elicited an isolated immediate asthmatic reaction that was inhibited with cromolyn sodium pretreatment. Patch testing to common rubber additives was negative. These results suggest that latex present in surgical rubber gloves and probably acting as inhalant allergen may produce occupational asthma in exposed subjects, probably by means of an IgE-mediated mechanism.
自1979年以来，已有多份关于天然乳胶引起接触性荨麻疹的报告得到充分记录。最近的病例报告表明，鼻炎和哮喘也可能是由于接触橡胶所致。我们描述了一名手术室护士，由于使用乳胶手术手套，在工作中接触了天然橡胶（乳胶）。25年后，她在为手术目的处理橡胶手套后出现了接触性荨麻疹、鼻结膜炎和急性哮喘。她休假时无症状。皮肤点刺试验显示对乳胶有即刻皮肤反应。用手术手套进行摩擦试验呈阳性。通过间接酶联免疫吸附测定法发现了针对乳胶的特异性IgE抗体。用乳胶提取物进行特异性支气管激发试验引发了孤立的即刻哮喘反应，该反应可被色甘酸钠预处理抑制。对常见橡胶添加剂的斑贴试验为阴性。这些结果表明，手术橡胶手套中存在的乳胶可能作为吸入性变应原，可能通过IgE介导的机制在接触者中引发职业性哮喘。
