Spaner D, Dolovich J, Tarlo S, Sussman G, Buttoo K
Department of Medicine, University of Toronto, Ontario, Canada.
J Allergy Clin Immunol. 1989 Jun;83(6):1135-7. doi: 10.1016/0091-6749(89)90457-0.
Rubber hypersensitivity is well described but usually as a contact dermatitis caused by chemicals added during the process of making natural latex or synthetic rubber. IgE-mediated reactions, mainly contact urticaria, have rarely been reported in Europe. We report a case of immediate hypersensitivity to latex. A 34-year-old female operating room nurse developed hand eczema to natural latex. On two occasions, while she was gloving for surgery, she had the following reactions: flushing, tachycardia, urticaria, angioedema, wheezing, and light-headedness. Prick and patch testing to thiuram mix, mercaptobenzothiazole, phenylenediamine mix, and carbamate mix (common rubber additives) were negative. Prick tests to natural latex elicited a 4+ reaction associated with immediate flushing, tachycardia, urticaria, and light-headedness. Five control subjects did not react. IgE antibodies to latex by RAST demonstrated 17.7% binding (control, 4%). This case demonstrates that natural latex can cause IgE-mediated symptoms. The route of exposure was cutaneous absorption of relevant latex allergens. As the use of latex rubber products continues to escalate, more cases are likely to occur.
橡胶超敏反应已有充分描述,但通常是由天然乳胶或合成橡胶制造过程中添加的化学物质引起的接触性皮炎。在欧洲,IgE介导的反应(主要是接触性荨麻疹)鲜有报道。我们报告一例对乳胶立即发生超敏反应的病例。一名34岁的女性手术室护士手部因天然乳胶出现湿疹。有两次,她在戴手术手套时出现了以下反应:脸红、心动过速、荨麻疹、血管性水肿、喘息和头晕。对秋兰姆混合物、巯基苯并噻唑、苯二胺混合物和氨基甲酸酯混合物(常见橡胶添加剂)进行点刺和斑贴试验均为阴性。对天然乳胶进行点刺试验引发了4+反应,并伴有立即出现的脸红、心动过速、荨麻疹和头晕。五名对照受试者无反应。通过放射性变应原吸附试验(RAST)检测,针对乳胶的IgE抗体显示结合率为17.7%(对照为4%)。该病例表明天然乳胶可引起IgE介导的症状。暴露途径是相关乳胶过敏原的皮肤吸收。随着乳胶橡胶制品的使用持续增加,可能会出现更多病例。