An allergy to latex (the natural rubber latex protein in rubber) is an immediate hypersensitivity (IgE mediated) reaction. This means that the speed of onset of features of a latex allergy occur over a short period of time (seconds+ (up to 6 hours)). Dermatological manifestations include itching, burning skin and urticaria. There may be associated angioedema and and even anaphylaxis. Other possible features include laryngeal oedema, rhino - conjunctivitis, and wheezing.
Those individuals with increased susceptibility include:
- history of atopy
- spina bifida
- multiple surgical procedures
- history of fruit or vegetable allergy
Assessment:
- detailed history
- RAST - measurement of antibodies to latex - not always positive in latex allergy subjects (1)
- if RAST is negative but there is a high index of suspicion then skin prick test should be undertaken - this should be undertaken in controlled conditions with resuscitation facilities available
Management:
- explanation of the condition (to patient and family)
- recommended carry adrenaline e.g. Epipen (R) - a patient should carry 2 Epipens (R) so that there is adrenaline available if the patient undergoes a late phase reaction some 6 hours after an immediate hypersensitivity reaction
- patient should wear a medical alert talisman or bracelet
- documentation of latex sensitivity in clinical notes
- if patient has to wear material that potentially contain latex (e.g. gloves) in occupation then alternative material should be worn e.g. neoprene, dermaprene, PVC, nitrile, polythene, polyurethane, acrylics