Sugimoto Mayumi, Ono Akemi, Yada Keigo, Mori Hiroki, Ishibashi Hiroki, Niki Noriko, Kagami Shoji
Department of Pediatrics, Tokushima University.
Department of Pediatric Surgery and Pediatric Endoscopic Surgery, Tokushima University.
J Med Invest. 2018;65(3.4):292-295. doi: 10.2152/jmi.65.292.
Natural rubber latex (NRL) allergy is one of the most important causes of severe anaphylaxis during medical intervention. We report a pediatric case of latex allergy with multiple surgical histories. A 12-year-old girl developed anaphylactic shock during the pyeloplasty for ureteropelvic junction restenosis. Latex gloves or medications used during the surgery were suspected to be the cause of anaphylactic shock. We diagnosed her latex allergy on the basis of the results that serum latex-specific IgE, skin prick tests of extract from NRL gloves and recombinant Hev b 6.02 solution were positive. Basophil activation test of NRL gloves was also positive, supporting the diagnosis of immediate allergic reactions caused by NRL. It was speculated that a history of multiple surgeries in infancy became a trigger of sensitization to latex in this patient. Reoperation after the diagnosis of NRL allergy was carried out in a latex-free environment and completed without any allergic symptoms. It would be necessary to perform the pre-screening of latex allergy to prevent the onset of latex allergy especially in the patients with multiple surgical histories. J. Med. Invest. 65:292-295, August, 2018.
天然橡胶乳胶（NRL）过敏是医疗干预期间严重过敏反应的最重要原因之一。我们报告一例有多次手术史的儿童乳胶过敏病例。一名12岁女孩在因输尿管肾盂连接处再狭窄进行肾盂成形术时发生过敏性休克。手术中使用的乳胶手套或药物被怀疑是过敏性休克的原因。根据血清乳胶特异性IgE、NRL手套提取物皮肤点刺试验和重组Hev b 6.02溶液皮肤点刺试验结果均为阳性，我们诊断她为乳胶过敏。NRL手套的嗜碱性粒细胞活化试验也呈阳性，支持NRL引起速发型过敏反应的诊断。据推测，该患者婴儿期的多次手术史成为其对乳胶致敏的触发因素。在诊断NRL过敏后，在无乳胶环境下进行再次手术，手术完成且未出现任何过敏症状。有必要对乳胶过敏进行术前筛查，以预防乳胶过敏的发生，尤其是对于有多次手术史的患者。《医学调查杂志》65:292 - 295，2018年8月。
