Cremer R, Hoppe A, Korsch E, Kleine-Diepenbruck U, Bläker F
Kinderkrankenhaus der Stadt Köln, Pädiatrische Klinik, Germany.
Eur J Pediatr. 1998 Jan;157(1):13-6. doi: 10.1007/s004310050758.
Type 1 allergy against natural rubber latex is an increasing problem in health care workers and children with spina bifida or urogenital malformations. The aim of our study was to evaluate the prevalence of latex IgE antibodies and cross-reacting fruit antibodies in patients with spina bifida compared with atopic and non-atopic controls. Risk factors for sensitization should be determined. Sera of 148 patients with spina bifida and 98 controls (44 with atopy) were screened for IgE antibodies against latex, banana and kiwi by fluorescence enzyme immunoassay (CAP system). Atopies, allergic symptoms after latex contacts and the number of operations were compiled by a questionnaire. Patients with spina bifida developed latex IgE antibodies (> or =0.7 kU/l) more frequently (40.5%) than atopic children (11.4%) or healthy controls (1.9%). All 18 symptomatic patients belonged to the spina bifida group and had high values of latex antibodies. The risk for developing latex antibodies increases with the number of operations. There was no difference in the history of atopic diseases and in a screening test of IgE antibodies against inhalative allergens between latex sensitized and not sensitized children with spina bifida. Antibodies against banana were more frequent in the latex sensitized children with spina bifida. (18.3% vs 3.4%, P = 0.002).
The high prevalence of latex antibodies in children with spina bifida justifies a primary prophylaxis by avoiding latex contacts, especially during anaesthesia and surgery, a correlation between the number of operations and the development of latex antibodies exists.
对天然橡胶乳胶的Ⅰ型过敏在医护人员以及患有脊柱裂或泌尿生殖系统畸形的儿童中是一个日益严重的问题。我们研究的目的是评估脊柱裂患者中乳胶IgE抗体和交叉反应性水果抗体的患病率,并与特应性和非特应性对照进行比较。应确定致敏的危险因素。通过荧光酶免疫测定法(CAP系统)对148例脊柱裂患者和98例对照(44例有特应性)的血清进行乳胶、香蕉和猕猴桃IgE抗体筛查。通过问卷调查收集特应性情况、乳胶接触后的过敏症状以及手术次数。脊柱裂患者出现乳胶IgE抗体(≥0.7 kU/l)的频率(40.5%)高于特应性儿童(11.4%)或健康对照(1.9%)。所有18例有症状的患者均属于脊柱裂组,且乳胶抗体值较高。出现乳胶抗体的风险随手术次数增加而升高。脊柱裂乳胶致敏和未致敏儿童在特应性疾病史以及吸入性过敏原IgE抗体筛查试验方面没有差异。脊柱裂乳胶致敏儿童中抗香蕉抗体更为常见(18.3%对3.4%,P = 0.002)。
脊柱裂儿童中乳胶抗体的高患病率证明通过避免乳胶接触进行一级预防是合理的,尤其是在麻醉和手术期间,手术次数与乳胶抗体的产生之间存在相关性。