Bernardini R, Novembre E, Lombardi E, Mezzetti P, Cianferoni A, Danti A D, Mercurella A, Vierucci A
Department of Pediatrics, A. Meyer Hospital, University of Florence, Vicenza, Italy.
J Urol. 1998 Nov;160(5):1775-8.
We determined the prevalence of and risk factors for latex sensitization in patients with spina bifida.
A total of 59 consecutive subjects 2 to 40 years old with spina bifida answered a questionnaire, and underwent a latex skin prick test and determination of serum IgE specific for latex by RAST CAP radioimmunoassay. We also noted the relationships of total serum IgE skin prick tests to common air and food allergens. In addition, skin prick plus prick tests were also done with fresh foods, including kiwi, pear, orange, almond, pineapple, apple, tomato and banana.
Latex sensitization was present in 15 patients (25%) according to the presence of IgE specific to latex, as detected by a skin prick test in 9 and/or RAST CAP in 13. Five latex sensitized patients (33.3%) had clinical manifestations, such as urticaria, conjuctivitis, angioedema, rhinitis and bronchial asthma, while using a latex glove and inflating a latex balloon. Atopy was present in 21 patients (35.6%). In 14 patients (23%) 1 or more skin tests were positive for fresh foods using a prick plus prick technique. Tomato, kiwi, and pear were the most common skin test positive foods. Univariate analysis revealed that a history of 5 or more operations, atopy and positive prick plus prick tests results for pear and kiwi were significantly associated with latex sensitization. Multivariate analysis demonstrated that only atopy and a history of 5 or more operations were significantly and independently associated with latex sensitization.
A fourth of the patients with spina bifida were sensitized to latex. Atopy and an elevated number of operations were significant and independent predictors of latex sensitization in these cases.
我们确定了脊柱裂患者中乳胶致敏的患病率及危险因素。
共59例年龄在2至40岁的连续脊柱裂患者回答了一份问卷，并接受了乳胶皮肤点刺试验以及通过RAST CAP放射免疫分析法测定血清乳胶特异性IgE。我们还记录了血清总IgE皮肤点刺试验与常见空气和食物过敏原的关系。此外，还对包括猕猴桃、梨、橙子、杏仁、菠萝、苹果、番茄和香蕉在内的新鲜食物进行了皮肤点刺加刺试验。
根据乳胶特异性IgE的存在情况，15例患者（25%）存在乳胶致敏，其中9例通过皮肤点刺试验检测到，13例通过RAST CAP检测到。5例乳胶致敏患者（33.3%）在使用乳胶手套和吹胀乳胶气球时出现了荨麻疹、结膜炎、血管性水肿、鼻炎和支气管哮喘等临床表现。21例患者（35.6%）存在特应性。14例患者（23%）使用点刺加刺技术对新鲜食物进行的1次或多次皮肤试验呈阳性。番茄、猕猴桃和梨是最常见的皮肤试验阳性食物。单因素分析显示，5次或更多手术史、特应性以及梨和猕猴桃的点刺加刺试验结果阳性与乳胶致敏显著相关。多因素分析表明，只有特应性和5次或更多手术史与乳胶致敏显著且独立相关。
四分之一的脊柱裂患者对乳胶致敏。在这些病例中，特应性和手术次数增加是乳胶致敏的重要且独立的预测因素。
