脊柱裂患者乳胶过敏的危险因素。

Risk factors for latex allergy in patients with spina bifida.

作者信息

Michael T, Niggemann B, Moers A, Seidel U, Wahn U, Scheffner D

机构信息

Division of Neuropaediatrics, Children's Hospital, Virchow Clinic of Humboldt University, Berlin, Germany.

出版信息

Clin Exp Allergy. 1996 Aug;26(8):934-9.

PMID:8877159

Abstract

OBJECTIVE AND METHODS

In order to study risk factors for latex allergy in patients with spina bifida, we investigated 165 patients with spina bifida (mean age 9 years). Besides answering a questionnaire, patients underwent skin-prick testing and determination of specific serum IgE to latex as well as a screening test for specific IgE to environmental allergens. A total of 80 patients (49%) were sensitized to latex according to the presence of specific IgE to latex.

RESULTS

Skin-prick tests (SPT) with high ammonia latex milk were performed in 81 of our patients with spina bifida and were positive in 36 patients (46%). Concordance of SPT with specific IgE in serum was good. Nineteen out of 165 patients suffered from a clinically relevant latex allergy: five patients had a history of systemic reactions to latex (e.g. severe bronchospasm, anaphylactic reactions), mostly during surgery. Fourteen patients reported clinical symptoms while inflating a balloon; all these 19 patients were sensitized to latex. Number of operations ranged from one to 26 (mean 5 operations). Concentration of specific IgE to latex in serum correlated well with increasing numbers of operations. Some 32/76 patients (41%) with spina bifida who were sensitized to latex showed an atopic disposition, while 21 out of 81 latex-negative patients (26%) were atopic. Of 300 consecutive sera (mean age of patients 9 years) sent to our laboratory for routine determination of specific IgE, 144 (48%) were positive in terms of specific IgE to environmental allergens, of which 247144 (17%) were sensitized to latex.

CONCLUSIONS

From our data we conclude that in order to minimize risk of severe systemic clinical reactions, all patients with spina bifida should be screened for their individual risk of latex allergy to plan preventive measures before operations. Main risk factors for latex allergy seem to be: more than five operations, atopic predisposition, history of clinical symptoms while inflating a balloon, and a sensitization with a CAP-class of > or = 4.

摘要

目的与方法

为研究脊柱裂患者发生乳胶过敏的危险因素，我们对165例脊柱裂患者（平均年龄9岁）进行了调查。患者除回答一份问卷外，还接受了皮肤点刺试验、血清乳胶特异性IgE测定以及环境过敏原特异性IgE筛查试验。根据血清中乳胶特异性IgE的存在情况，共有80例患者（49%）对乳胶致敏。

结果

我们对81例脊柱裂患者进行了高氨乳胶乳剂的皮肤点刺试验，其中36例（46%）呈阳性。皮肤点刺试验与血清特异性IgE的一致性良好。165例患者中有19例患有临床相关的乳胶过敏：5例患者有乳胶全身反应史（如严重支气管痉挛、过敏反应），主要发生在手术期间。14例患者在吹气球时有临床症状；这19例患者均对乳胶致敏。手术次数从1次到26次不等（平均5次）。血清中乳胶特异性IgE的浓度与手术次数增加密切相关。约32/76例（41%）对乳胶致敏的脊柱裂患者表现出特应性体质，而81例乳胶阴性患者中有21例（26%）为特应性体质。在连续送到我们实验室进行特异性IgE常规测定的300份血清（患者平均年龄9岁）中，144份（48%）环境过敏原特异性IgE呈阳性，其中24/144份（17%）对乳胶致敏。