Thomas P, Lukacs A, Rueff F, Przybilla B
Dermatologische Klinik und Poliklinik, Universität München.
Dtsch Med Wochenschr. 1995 Apr 28;120(17):609-12. doi: 10.1055/s-2008-1055385.
A nearly three-year-old boy with a genitourinary malformation, which had already been operated on several times, developed generalized urticaria, facial swelling and bronchospasm within 15 minutes of the induction of anaesthesia. The signs quickly responded to the administration of methylprednisolone (32 mg), clemastine (10 mg) and ranitidine (25 mg). There was a twofold positive immediate reaction in the prick test to natural rubber latex (white and brown), and specific IgE was demonstrated against the latex (2.58 kU/l). On the other hand, prick tests with perioperatively administered drugs and an oral provocation test with an antibiotic administered in the perioperative period were negative. The history of itching caused by an indwelling bladder catheter, vesicles on the lips after sucking on a rubber dummy and the described findings on examination both point to the natural rubber latex as the responsible allergen. No complications occurred three months later during a surgical intervention under administration of steroids and H1- and H2-receptor antagonists, as well as avoidance of materials made of natural rubber latex.
一名近三岁的男孩患有泌尿生殖系统畸形，已经接受过多次手术。在麻醉诱导后15分钟内，他出现了全身性荨麻疹、面部肿胀和支气管痉挛。这些症状在给予甲泼尼龙（32毫克）、氯马斯汀（10毫克）和雷尼替丁（25毫克）后迅速得到缓解。对天然橡胶乳胶（白色和棕色）的点刺试验呈两倍阳性即刻反应，并且检测到针对乳胶的特异性IgE（2.58千单位/升）。另一方面，对围手术期使用的药物进行的点刺试验以及对围手术期使用的一种抗生素进行的口服激发试验均为阴性。留置膀胱导管引起瘙痒的病史、吸吮橡胶奶嘴后嘴唇上出现水疱以及检查中描述的发现均表明天然橡胶乳胶是致敏原。三个月后，在使用类固醇、H1和H2受体拮抗剂并避免使用天然橡胶乳胶制品的情况下进行手术干预，未发生并发症。
