ABSTRACT
BACKGROUND: Allergic reactions to ethylene oxide (EtO-treated products have occurred in several children with myelomeningoceles. OBJECTIVE: The object of this study was to define the prevalence and significance of EtO-specific IgE among the children in our myelomeningocele clinic. METHODS: The study population comprised three groups: children clinic. METHODS: The study population comprised three groups: children with myelomeningoceles, chronically ill controls (defined as children who had undergone at least three major operations), and well-child controls. Serum specimens were collected from each child, and a commercially available ELISA designed to identify IgE directed against both EtO and latex was performed on the specimens. RESULTS: Seventeen of 75 (23%) children with myelomeningoceles had antibodies directed against EtO, as did 1 of 26 (4%) chronically ill controls. None of the 25 well controls had detectable levels of anti-EtO IgE. Children with antibodies directed against EtO were more likely to be atopic (p = 0.007) and to have a shunt (p = 0.021) and were markedly more likely to have antibodies directed against latex (p = 0.001). On average they had undergone more shunt revisions and other operations than had children without anti-EtO antibodies. CONCLUSION: During the period of study no child had anaphylaxis thought to have been due to EtO exposure.
Subject(s)
Drug Hypersensitivity/complications , Ethylene Oxide/immunology , Spinal Dysraphism/complications , Adolescent , Antibodies/analysis , Child , Child, Preschool , Humans , Infant , Latex/immunology , Reference Values , Spinal Dysraphism/immunologyABSTRACT
We studied the prevalence of latex-specific IgE among the children in our myelomeningocele clinic and several groups of controls using skin tests, a commercially available ELISA and an in-house RAST. Thirty-nine of 83 (47%) children with myelomeningocele had antibodies directed against latex as did 6 of 40 (15.7%) chronically ill controls, 4 of 105 (3.8%) medical controls and 2 of 75 (2.7%) well controls. Within each study group the likelihood of a positive skin test increased with the number of operations the subject had undergone. Children with myelomeningocele were much more likely to have antibodies to latex than were chronically ill controls with similar surgical histories. A retrospective chart review of 18 years and a total of 646 operations disclosed only one episode of intraoperative anaphylaxis which appeared to be related to latex within our study group.
Subject(s)
Hypersensitivity , Immunoglobulin E/immunology , Latex , Meningomyelocele/immunology , Adolescent , Adult , Anaphylaxis , Antibody Formation , Child , Child, Preschool , Enzyme-Linked Immunosorbent Assay , Humans , Retrospective Studies , Skin TestsABSTRACT
Chronic illness affects all members of the family, including siblings. Siblings of children with myelomeningocele have been studied infrequently. This descriptive study examined the perceptions and concerns of the school-age siblings of children with myelomeningocele and compared sibling responses with maternal perceptions of the sibling relationship. The effects of age, birth order, and gender were also examined. Fifteen children and their mothers participated in the study. Data were collected through a sibling interview and maternal survey. Qualitative analysis of the sibling responses revealed a high level of empathy and concern for their brothers and sisters with myelomeningocele. Maternal responses yielded similar findings. No statement could be made regarding the effects of age, birth order, or gender upon the sibling relationship. Nurses are in a unique position to assess the perceptions and concerns of siblings, and to intervene to ensure that their needs are met and their contributions to family life recognized.
