Novembre E, Bernardini R, Brizzi I, Bertini G, Mugnaini L, Mezzetti P, Vierucci A
Dipartimento di Pediatria, Università degli Studi di Firenze, Italia.
Pediatr Med Chir. 1996 Mar-Apr;18(2):173-6.
Natural rubber latex allergy is responsible for a wide spectrum of clinical symptoms ranging from rhinoconjunctivitis to severe anaphylaxis both in adults and children. The aim of this study was to investigate the prevalence and clinical significance of latex sensitization in children evaluated for allergic disease. Four hundred fifty three consecutive children evaluated for allergic disease in a university outpatient allergy clinic were screened. A detailed clinical history with particular attention to the past surgical history and the use of natural dummies or pacifiers was obtained. Skin prick tests (SPT) for the more important inhalants and foods were performed on all children. In patients with positive latex SPT, latex challenge and RAST as well as patch test with latex were also done. Ten out 326 atopic children (3%) presented positive skin test to latex, but only five (1.5%) also had a positive clinical history to latex exposure. Latex challenge was positive in 3/9 positive latex SPT children. None of the non-atopic children had positive skin test to latex or symptoms to latex exposure. A history of previous surgery was found in 5/10 positive latex SPT children, in 63/316 negative latex SPT atopic children (p < 0.05) and in 23/127 non-atopic children. The use of natural dummies or pacifiers was similar in atopic (positive or negative latex SPT) and non-atopic children. RAST to latex was positive in 5/10 positive latex SPT children. Latex SPT sensitivity was demonstrated in a moderate proportion of atopic children (3%) even if only half of these patients had a positive clinical history to latex exposure. Latex challenge was positive in 3 out 9 latex SPT positive children. SPT to latex is a safe and simple method to detect sensitive patients and should be included in the routine PT series of inhalant allergens.
天然橡胶乳胶过敏在成人和儿童中都会引发从鼻结膜炎到严重过敏反应等广泛的临床症状。本研究旨在调查因过敏性疾病接受评估的儿童中乳胶致敏的患病率及其临床意义。对在大学门诊过敏诊所连续接受过敏性疾病评估的453名儿童进行了筛查。获取了详细的临床病史，尤其关注既往手术史以及天然奶嘴或安抚奶嘴的使用情况。对所有儿童进行了针对更重要的吸入性过敏原和食物的皮肤点刺试验（SPT）。对于乳胶SPT呈阳性的患者，还进行了乳胶激发试验、放射性变应原吸附试验（RAST）以及乳胶斑贴试验。326名特应性儿童中有10名（3%）对乳胶皮肤试验呈阳性，但只有5名（1.5%）对乳胶接触也有阳性临床病史。9名乳胶SPT呈阳性的儿童中有3名乳胶激发试验呈阳性。非特应性儿童中没有对乳胶皮肤试验呈阳性或有乳胶接触症状的。10名乳胶SPT呈阳性的儿童中有5名有既往手术史，316名乳胶SPT呈阴性的特应性儿童中有63名（p < 0.05），127名非特应性儿童中有23名有既往手术史。特应性儿童（乳胶SPT阳性或阴性）和非特应性儿童使用天然奶嘴或安抚奶嘴的情况相似。10名乳胶SPT呈阳性的儿童中有5名乳胶RAST呈阳性。即使这些患者中只有一半对乳胶接触有阳性临床病史，仍有一定比例（3%）的特应性儿童表现出乳胶SPT敏感性。9名乳胶SPT阳性儿童中有3名乳胶激发试验呈阳性。乳胶SPT是检测敏感患者的一种安全、简单的方法，应纳入吸入性过敏原的常规点刺试验系列中。
