The prevalence of latex allergy in children seen in a university hospital allergy clinic.

Natural rubber latex allergy is responsible for a wide spectrum of clinical symptoms, ranging from rhinoconjunctivitis to severe anaphylaxis, in both adults and children. An association between allergy to latex and allergy to various fruits has been reported. This study investigated the prevalence and clinical significance of latex sensitization in children seen in a university hospital allergy clinic. A total of 453 consecutive children were screened in a 7-month period. A detailed clinical history with particular attention to the past surgical history and the eventual presence of latex- or food-induced allergic symptoms was obtained. Skin prick tests (SPT) for the more important inhalant allergens and foods were performed on all children. In patients with positive latex SPT, latex challenge and additional SPT for some fresh foods (avocado, pineapple, apricot, grape, banana, pear, apple, orange, almond, and chestnut) were also performed. RAST for the same food antigens, as well as patch test with latex and a standard battery of contact allergens, was also done. Of 326 atopic children, 10 (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 nonatopic 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 nonatopic children. RAST to latex was positive in 5/10 positive-latex-SPT children. Associated fruit-specific IgE (SPT and/or RAST) were found in all latex-symptomatic children and in 2/5 latex-asymptomatic children. Apple, kiwi, and chestnut were the most common SPT-positive foods. Only one patient with clinical allergy to latex and positive skin tests to fruits had a history of clinical symptoms after ingestion of kiwi and orange. The natural history of the positive-latex-SPT children without clinical reactions to latex exposure and the clinical significance of the association of latex and fruit sensitivity require further studies.

[Allergy to latex evaluated at an allergology clinic]. / L'allergia al latice in un ambulatorio allergologico.

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.

[Latex allergy in children: description of two cases]. / Allergia al latice in età pediatrica: descrizione di due casi clinici.

Here we present two cases of latex hypersensitivity. The clinical manifestations were conjunctivitis, urticaria, angioedema and dermatitis. The patients presented positive skin prick test (SPT) to latex with a commercial extract and by pricking through a latex surgical glove. Radioallergosorbent test (RAST) to latex and patch testing to common additives and to latex were negative. Skin prick tests with fruits (banana, kiwi, pineapple, apricot, avocado, grape) were positive but children presented no symptoms after ingestion of these fruits. These case reports are presented to heighten awareness of the potential of latex allergy also in children.

[The new parents. The importance of the pediatrician-child-parent triad]. / I nuovi genitori. Importanza della triade pediatra-bambino-famiglia.

During these past years pediatricians have been more and more interested to the adolescent's matters. Undoubtedly adolescent's behavioural disturbances are to be bound to a childhood spent in a wrong way, and contemporarily managed by parents who, despite their maximum dedication, have not "trained" their children according to specific "fundamentals", probably because also they themselves, when children, have not been submitted to them.

[The emotional rapport between mother and child during the first months of life]. / Rapporto emozionale tra la madre e il bambino nei primi mesi di vita.

Feeding children involves a mutual interaction between their parents and them; interaction in which everyone is influenced by and, contemporarily, influences the others. In fact the act of administering food is considered to be fundamental inside the relationship between the mother and her child. Such a relationship can supply consequences that are important for the children's physical, emotional and cognitive growth, particularly in their first two years of life. Therefore, any time a child arrives at the pediatrician's attention showing a nourishment matter, and anamnesis and examination are indicative of a lack of evidence that may address to a physical disease, the next zone to be indagated must be the existing relationship between the child and his family.

[The pediatrician and the child with a psychosomatic disease: some reflections]. / Il pediatra ed il bambino con malattia psicosomatica: alcune riflessioni.

Not very carefully taking into account a possible psychosomatic pathology in children can, in many occasions, cause the pediatrician to make seriously wrong diagnostic, prognostic and therapeutic evaluations. As this is valid at any age, the authors affirm that particularly at the evolutive age, and since the first months of life, many circumstances occur in which the functional trouble can sometimes a serious organic pathology.

[Recurrent cystitis in children: do predisposing factors exist for its onset?]. / Le cistiti recidivanti nel bambino: esistono cause che favoriscono la loro insorgenza?

It is known that a great number of subjects, mainly little girls, frequently go to pediatric's observation for recurrent episodes of pollakiuria, dysuria or burning miction. They often complain enuresis, sometimes tenesmus so intense that they arrive at the incontinence (urge incontinence). Many of these cases, quickly defined as cystitis, really revealed that they weren't. Repetitively negative bacteriologic examinations allow us to classify them as "sham syndromes", as Stephens called them. According to what we said above, we wondered whether any recurrent cystitis are not favoured by missed observation of definite rules.

[The technique of pediatric examination of an adolescent with personality problems]. / La tecnica della visita pediatrica all'adolescente con problemi del carattere.

The authors suggest the behaviour which the pediatrician has to keep with the adolescent and his family. The authors believe that in the "puberal spurt" period the pediatrician must inform the parents about the mould change which the young will inevitably have.