Jäger D, Engelke T, Rennert S, Czuppon A B, Baur X
Berufsgenossenschaftliches Forschungsinstitut für Arbeitsmedizin (BGFA), Institut an der Ruhr-Universität Bochum.
Pneumologie. 1993 Aug;47(8):491-6.
Latex proteins bound to the powder of latex gloves are potent aeroallergens which can cause severe immediate-type allergic reactions of the upper and lower respiratory tract. To evaluate the clinical relevance of positive skin prick tests or IgE antibodies to latex we developed a sequence of provocation tests for the diagnosis of latex induced rhinitis or asthma. 14 patients are presented, 11 working in the medical field. All had positive skin prick test to latex milk and specific IgE-antibodies to a latex glove extract, six were atopic. 14 reported symptoms of the upper respiratory tract, 11 dyspnea related to latex contact. Nasal provocation with a suspension of powder from latex gloves or a glove extract could prove latex rhinitis in all cases by rhinomanometry. Bronchial obstruction was seen in four cases with one severe asthma attack in this test. The workplace-related provocation test with latex gloves was less sensitive for latex-asthma (3/9 positive) than the direct bronchial provocation test with a latex glove extract (6/7 positive), the three latex allergic patients without a history of dyspnea remaining negative in both. Provocation tests are highly sensitive for latex allergy of the respiratory tract and therefore of special importance in the diagnostic procedure.
与乳胶手套粉末结合的乳胶蛋白是强效的空气变应原，可引起上、下呼吸道严重的速发型过敏反应。为评估皮肤点刺试验阳性或针对乳胶的IgE抗体的临床相关性，我们开发了一系列激发试验，用于诊断乳胶诱发的鼻炎或哮喘。本文介绍了14例患者，其中11例在医疗领域工作。所有患者对乳胶乳剂的皮肤点刺试验均为阳性，且对乳胶手套提取物有特异性IgE抗体，6例为特应性体质。14例报告有上呼吸道症状，11例有与乳胶接触相关的呼吸困难。通过鼻阻力测量法，用乳胶手套粉末悬液或手套提取物进行鼻腔激发试验，在所有病例中均能证实乳胶性鼻炎。在该试验中，4例出现支气管阻塞，其中1例发生严重哮喘发作。与工作场所相关的乳胶手套激发试验对乳胶性哮喘的敏感性低于用乳胶手套提取物进行的直接支气管激发试验（分别为3/9阳性和6/7阳性），3例无呼吸困难病史的乳胶过敏患者在两种试验中均为阴性。激发试验对呼吸道乳胶过敏高度敏感，因此在诊断过程中具有特殊重要性。
