ABSTRACT
Introducción: La prevalencia de sensibilización al látex es variable. Se describen diversos factores de riesgo para la sensibilización al látex, como riesgo genético, atopia y múltiples intervenciones quirúrgicas. Objetivo: Caracterizar los pacientes con sospecha de alergia al látex, analizar sus características clínicas y factores de riesgo. Pacientes y método: Estudio retrospectivo, descriptivo, en niños derivados a la Unidad de Inmunología pediátrica por sospecha de alergia al látex y para confirmación diagnóstica. Se revisaron síntomas por contacto o exposición a materiales con látex. Se identificó factores de riesgo para la sensibilización al látex: patologías con múltiples intervenciones quirúrgicas (espina bífida, mielomeningocele, escoliosis y alteraciones nefrourológicas), atopia (rinitis o asma, dermatitis atópica), y se realizó prick test y/o IgE específica para látex. Se efectuó un modelo de regresión logística multivariado para asociar síntomas de exposición al látex con enfermedades de base y condiciones de riesgo. Resultados: Se reclutaron 106 pacientes, de los cuales 50 fueron analizables. El 96% eran mayores de 5 años de edad al momento del diagnóstico. La mayoría de los factores de riesgo descritos en la literatura eran observables en estos pacientes (múltiples cirugías, malformaciones neurológicas y nefrourológicas, intervenciones quirúrgicas antes del año de edad y cateterismo vesical repetido). Luego de la exposición, las manifestaciones cutáneo-mucosas fueron las más frecuentes (52%), seguidas por las respiratorias (36%). El 100% de los pacientes estaban sensibilizados al látex. Conclusión: La sensibilización y alergia al látex es un problema relevante en niños con factores de riesgo. Los resultados mostrados plantean importantes desafíos en relación con medidas preventivas.
Introduction: The prevalence of latex sensitisation varies according to the population studied. There are various risk factors that increase latex sensitisation, such as genetic risk, atopy, and multiple surgeries. Objective: To characterise patients referred to an Immunology Unit with suspected latex allergy, and to analyse their clinical features and risk factors. Patients and method: A retrospective, descriptive study was conducted on children suspected of latex allergy. Their medical records were reviewed in order to assess symptoms with contact or exposure to latex materials. Known risk factors to latex sensitisation, such as pathologies requiring repeated surgery (spina bifida, myelomeningocele, scoliosis and nephro-urological alterations), atopy (rhinitis, asthma, atopic dermatitis) were investigated. A prick test and/or specific IgE to latex were also performed. A multivariate logistic regression model was performed to find associations between symptoms triggered by exposure to latex with underlying diseases and other risk conditions. Results: A total of 106 patients were enrolled in the study, of whom 50 were evaluable. At diagnosis 96% of patients were older than five years. Most of the risk factors described were observable in these patients, such as multiple surgeries, neurological and nephro-urological malformations, surgery before one year-old, and repeated bladder catheterisation. After latex exposure, mucous cutaneous manifestations were the most common (52%), followed by respiratory symptoms (36%). All patients were sensitised and allergic to latex. Conclusion: Latex allergy is a significant problem in children with risk factors. The results shown in this study raise important challenges for preventive measures and awareness.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Young Adult , Immunoglobulin E/immunology , Skin Tests/methods , Latex Hypersensitivity/epidemiology , Logistic Models , Prevalence , Multivariate Analysis , Retrospective Studies , Risk Factors , Latex Hypersensitivity/diagnosis , Latex Hypersensitivity/etiology , Hospitals, PediatricABSTRACT
Los individuos alérgicos a látex pueden presentan reacciones mediadas por inmunoglobulina E (IgE) principalmente a frutas como cambur (banana, plátano), aguacate (palta), castaña y kiwi, lo cual se conoce como síndrome látex-frutas (SLF). Conocer la prevalencia del síndrome látex-frutas en una población conformada por los estudiantes de postgrado de la Facultad de Odontología de la Universidad Central de Venezuela (UCV) previamente diagnosticados con hipersensibilidad tipo I al látex. Se realizó un cuestionario a 27 participantes para conocer los antecedentes de atopia y reacciones alérgicas a frutas y vegetales así como también los factores de riesgo. También se diagnosticó la hipersensibilidad tipo I a aguacate, cambur, kiwi y tomate, mediante la prueba cutánea por técnica de punción superficial como prueba in vivo y un método ELISA utilizando el ENEASystem III como prueba in vitro. Estas dos pruebas diagnósticas arrojaron un total de 11/27 (41%) participantes con el síndrome látex-frutas. Referente a los factores considerados como de riesgo, 6 (55%) tenían antecedentes de atopia, 4 (36%) reportaron antecedentes familiares de alergia y 8 (73%) habían sido sometidos a intervenciones quirúrgicas. En este estudio se encontró una alta prevalencia del síndrome látex-frutas en la población estudiada. Los datos obtenidos sugieren un comportamiento dependiente entre la atopia y los otros factores de riesgo y el síndrome látex-frutas.
The individuals who are allergic to latex reactions are mediated by immunoglobulin E (IgE) mainly of fruit such as banana, avocado, chestnuts and kiwi, which is known as latex-fruit syndrome (LFS). To determine the prevalence of the latex-fruit syndrome in a group of dentists at the School of Dentistry at the Central University of Venezuela (UCV) previously diagnosed with type I hypersensitivity to latex. We conducted a questionnaire to find out the history of atopia, symptoms and allergic reactions to fruits and vegetables and the risk factors. Also we diagnosed type I hypersensitivity to avocado, banana, kiwi and tomato through the skin test technique of "prick by prick " as in vivo test and an ELISA method using the ENEASystem III as evidence in vitro. These two diagnostic tests yielded a total of 11/27 (41 %) participants with the latex-fruit syndrome. Concerning the factors considered as risk, 6 (55 %) had atopia, 4 (36 %) family history of allergy and 8 (73 %) had surgical interventions. This study found a high prevalence of the latex-fruit syndrome in the group studied. The data obtained suggest a behavior dependent between the atopia and other factors of risk and the syndrome latex - fruit.
Subject(s)
Humans , Male , Female , Food Hypersensitivity , Latex Hypersensitivity/complications , Latex Hypersensitivity/diagnosis , Immunoglobulin E/analysis , Students, Dental , Latex Hypersensitivity , Skin TestsABSTRACT
Diversos estudios han demostrado que entre un 20% y un 60% de los individuos alérgicos a látex presentan reacciones mediadas por inmunoglobulina E (IgE) a una amplia variedad de alimentos, principalmente a frutas como el cambur (banana, plátano) el aguacate, la castaña y el kiwi, lo cual se conoce como síndrome látex-frutas. El odontólogo debe conocer esta reacción cruzada de alergia a fin de evitar situaciones que puedan poner en riesgo al paciente si no se toman las medidas que garanticen un ambiente seguro libre de látex
Studies have shown that between 20% and 60% of individuals allergic to latex have IgE-mediated reactions (IgE) to a wide variety of foods, mainly fruits like banana, avocado, sweet chestnut and kiwi, which is called latex-fruit syndrome. The dentist should be aware of this allergy cross-reaction to avoid situations that may endanger the patient if not taken measures to ensure a safe environment free of latex
Subject(s)
Humans , Male , Female , Food Hypersensitivity , Latex Hypersensitivity/diagnosis , Latex Hypersensitivity/immunology , General Practice, DentalABSTRACT
Spinach (Spinacia oleracea) is a widely consumed vegetable, but rarely causes allergic reactions. Spinach contains plenty of histamine derivatives, so it is sometimes difficult to distinguish food allergy from pharmacologic effect of histamine itself in susceptible individuals. Latex exhibits strong cross reactivity with proteins from different fruits, vegetables, and grains, which is called as latex fruit syndrome. A 27 year old female visited emergency room with hives, facial swelling, dyspnea and palpitation immediately after meal. She had been suffering from latex allergy and had experienced an episode of anaphylaxis after eating eggplant 5 months earlier. Skin prick test with spinach extract was positive. Specific IgE to spinach antigens was detected by ELISA. ELISA inhibition test revealed that there is cross reactivity between latex and spinach. Two IgE binding components were detected between 22kD and 36kD, and another two between 16kD and 22kD on IgE-immunoblot analysis.