Latex Allergy in Dental Care

SUMMARYNatural rubber latex is found in numerous medical and dental products. Adverse latex reactions in dental patients and practitioners have significantly increased since the introduction of universal precautions for infection control. These reactions range from contact dermatitis to potentially life-threatening hypersensitivity. Patients with a history of spina bifida, urogenital anomalies, multiple surgical procedures, allergic reactions or atopy, health care personnel and latex production workers are at increased risk of latex allergy. Diagnosis is based on a combination of clinical history and laboratory tests. Identification of latex sources and the avoidance of latex exposure are critical for protecting both dental patients and dental personnel.

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Sensitization to allergen components from natural rubber latex (Hevea brasiliensis) in a 15-year old girl undergoing multiple surgical procedures

Journal of Case Reports in Medicine ◽

10.25149/jcrm.v8i3.212 ◽

2019 ◽

Vol 8 (3) ◽

Author(s):

Shigemi Yoshihara ◽

Motoko Nakayama ◽

Masaya Kato ◽

Yusuke Ando ◽

Manabu Miyamoto ◽

...

Keyword(s):

Spina Bifida ◽

Anaphylactic Shock ◽

Natural Rubber Latex ◽

Clinical History ◽

Specific Ige ◽

Allergic Reactions ◽

Rubber Latex ◽

Allergen Components ◽

History Of ◽

Fruit Syndrome

This paper describes a case of anaphylaxis due to latex exposure during surgery. Allergic reactions to latex during surgery have been described in spinal bifida patients. The case presented in our manuscript is a 15-year old girl who experienced an anaphylactic reaction during her 12th surgery of giant hairy nevus on the thigh. She had a history of oral pruritus after ingestion of chestnut suggesting latex-fruit syndrome. Specific IgE was positive to latex and the allergen components Hev b 1, 3, 5 and 6.02. The diagnosis was latex-allergy due to sensitization obtained after multiple surgeries, possibly due to the contact of latex-containing gloves. Anaphylactic shock during surgery due to NRL allergy is being reported continuously. To prevent allergic reactions during surgery in patients who undergo multiple surgeries, not only in Spina Bifida (SB) patients, frequent analyses of specific IgE to NRL are essential as well as the documentation of the clinical history after ingestion of latex-fruit syndrome related foods. Measurement of specific IgE to allergen components from NRL might be useful in the diagnosis of NRL allergy and in the investigation of the route of NRL sensitization.

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Natural Rubber Latex Allergy

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2002.sepoct01 ◽

2002 ◽

Vol 7 (5) ◽

pp. 1-3

Author(s):

Jon Musmand ◽

Christopher R. Brigham

Keyword(s):

Natural Rubber ◽

Natural Rubber Latex ◽

Clinical Manifestations ◽

Clinical History ◽

Specific Ige ◽

Latex Allergy ◽

Rubber Latex ◽

Latex Gloves ◽

Care Workers ◽

Air Passage

Abstract Natural rubber latex (NRL) allergy is discussed in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, in Section 8.5, Natural Rubber Latex Allergy, and refers to an IgE-mediated immediate hypersensitivity reaction to one or more protein allergens in latex devices, especially gloves. Among health care workers, NRL allergy is the most common cause of occupationally induced rhinoconjunctivitis and asthma, and clinical manifestations range from dermatitis and contact urticaria, allergic rhinoconjunctivitis, and asthma, to anaphylaxis. Evaluating physicians must be cognizant that a suggestive clinical history is necessary but not sufficient to diagnose NRL allergy, and FDA-approved NRL-specific IgE serum tests may have sensitivity as low as 75% and up to 27% false-positive results. No FDA-approved skin test reagent is available for testing. In evaluating impairment due to NRL allergy, evaluators should determine if the individual's problem can be resolved by avoidance of wearing latex gloves. Most patients who have asthma or air passage disruption impairment due to NRL have problems with bronchospasm only when they are exposed, and these patients may not necessarily have any ratable impairment due to NRL (but individuals who have atopic dermatitis may have ongoing symptoms due to pre-existing allergic rhinitis). Efforts to decrease the incidence of NRL allergy have been encouraging, and some patients diagnosed with NRL allergy may return to work in a latex-safe environment.

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NIOSH alert: preventing allergic reactions to natural rubber latex in the workplace.

10.26616/nioshpub97135 ◽

1997 ◽

Keyword(s):

Natural Rubber ◽

Natural Rubber Latex ◽

Allergic Reactions ◽

Rubber Latex

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Anaphylactic Death: A New Forensic Workflow for Diagnosis

Healthcare ◽

10.3390/healthcare9020117 ◽

2021 ◽

Vol 9 (2) ◽

pp. 117

Author(s):

Massimiliano Esposito ◽

Angelo Montana ◽

Aldo Liberto ◽

Veronica Filetti ◽

Nunzio Di Nunno ◽

...

Keyword(s):

Clinical History ◽

Rapid Onset ◽

Mean Value ◽

Laryngeal Edema ◽

Tryptase Level ◽

Antibody Staining ◽

Life Threatening ◽

History Of ◽

Immunohistochemical Techniques

Anaphylaxis is a life-threatening or fatal clinical emergency characterized by rapid onset, and death may be sudden. The margin of certainty about the diagnosis of anaphylactic death is not well established. The application of immunohistochemical techniques combined with the evaluation of blood tryptase concentrations opened up a new field of investigation into anaphylactic death. The present study investigated eleven autopsy cases of anaphylactic death, carried out between 2005 and 2017, by the Departments of Forensic Pathology of the Universities of Foggia and Catania (Italy). An analysis of the medical records was carried out in all autopsies. Seven autopsies were carried out on males and four on females. Of the eleven cases, one showed a history of asthma, one of food ingestion, two of oral administration of medications, six did not refer any allergy history, and one subject was unknown. All cases (100%) showed pulmonary congestion and edema; 7/11 (64%) of the cases had pharyngeal/laryngeal edema and mucus plugging in the airway; only one case (9%) had a skin reaction that was found during external examination. Serum tryptase concentration was measured in ten cases, and the mean value was 133.5 µg/L ± 177.9. The immunohistochemical examination using an anti-tryptase antibody on samples from the lungs, pharynx/larynx, and skin site of medication injection showed that all cases (100%) were strongly immunopositive for anti-tryptase antibody staining on lung samples; three cases (30%) were strongly immunopositive for anti-tryptase antibody staining on pharyngeal/laryngeal samples; and eight cases (80%) were strongly immunopositive for anti-tryptase antibody staining on skin samples. We conclude that a typical clinical history, blood tryptase level >40 µg/L, and strongly positive anti-tryptase antibody staining in the immunohistochemical investigation may represent reliable parameters in the determination of anaphylactic death with the accuracy needed for forensic purposes.

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Past medical history of tumors other than meningioma is a negative prognostic factor for tumor recurrence in meningiomas WHO grade I

Acta Neurochirurgica ◽

10.1007/s00701-021-04780-9 ◽

2021 ◽

Author(s):

Annamaria Biczok ◽

Philipp Karschnia ◽

Raffaela Vitalini ◽

Markus Lenski ◽

Tobias Greve ◽

...

Keyword(s):

Medical History ◽

Tumor Recurrence ◽

Clinical History ◽

Study Endpoint ◽

Past Medical History ◽

Who Grade ◽

Increased Risk ◽

History Of ◽

Meningioma Recurrence ◽

The Impact

Abstract Background Prognostic markers for meningioma recurrence are needed to guide patient management. Apart from rare hereditary syndromes, the impact of a previous unrelated tumor disease on meningioma recurrence has not been described before. Methods We retrospectively searched our database for patients with meningioma WHO grade I and complete resection provided between 2002 and 2016. Demographical, clinical, pathological, and outcome data were recorded. The following covariates were included in the statistical model: age, sex, clinical history of unrelated tumor disease, and localization (skull base vs. convexity). Particular interest was paid to the patients’ past medical history. The study endpoint was date of tumor recurrence on imaging. Prognostic factors were obtained from multivariate proportional hazards models. Results Out of 976 meningioma patients diagnosed with a meningioma WHO grade I, 416 patients fulfilled our inclusion criteria. We encountered 305 women and 111 men with a median age of 57 years (range: 21–89 years). Forty-six patients suffered from a tumor other than meningioma, and no TERT mutation was detected in these patients. There were no differences between patients with and without a positive oncological history in terms of age, tumor localization, or mitotic cell count. Clinical history of prior tumors other than meningioma showed the strongest association with meningioma recurrence (p = 0.004, HR = 3.113, CI = 1.431–6.771) both on uni- and multivariate analysis. Conclusion Past medical history of tumors other than meningioma might be associated with an increased risk of meningioma recurrence. A detailed pre-surgical history might help to identify patients at risk for early recurrence.

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