allergies

Latex Allergy - Diagnosis and Therapy

Latex allergy: introduction

Latex allergy is a growing health problem in our country, although, unfortunately, it is still quite undervalued. To understand the seriousness (often minimized) of latex allergy, we report a data received from the FDA ( Food and Drug administration ): between 1988 and 1993, the FDA received over a thousand reports of allergic reactions to latex, of which some mortals. In the last decade, reports of latex allergies continue to multiply from year to year, especially in the health sector.

From this consideration, the need arises to perfect the diagnostic strategies and the therapeutic approach, in order to reduce the severity of the symptoms and reduce the risk of complications, probably triggered by more frequent and repeated contacts with latex.

Diagnosis

Diagnostic tests to ascertain latex allergy are performed on the basis of clinical and laboratory data; therefore, we distinguish the clinical diagnosis from the laboratory one.

  1. Clinical diagnosis for latex allergy: it consists in direct medical observation of injuries triggered by latex allergy, and in the collection of medical history. This clinical investigation sets the objectives to ascertain the symptoms, the severity and the progression (if any) of the allergy, in addition to detecting the presence of possible risk factors (eg asthma, dermatitis, genetic predisposition, etc.).
  2. Laboratory diagnosis for latex allergy: it uses in vivo skin tests and in vitro serological tests.

The most used IN VIVO diagnostic tests are:

  • Prick-test: diagnostic test par excellence, used to ascertain allergies in general, and latex in particular. The test consists in putting the subject's skin in contact with different commercial latex extracts; subsequently, the skin is pointed with a sterile lancet. The formation of wheals or vesicles in that particular point indicates the positivity to the test; the size of the skin lesions is proportional to the severity of the latex allergy.
  • Prick by prick-test: after placing the skin of the forearm in contact with a piece of latex glove, it will be pointed with a thin needle.
  • Patch test: this test is useful for ascertaining a suspected allergy to latex additives. The patient's skin is placed in contact with a plaster soaked in an allergenic substance, left adhered to the skin for 48 hours. The reading of the test is performed, respectively, 30 minutes and 24 hours after removal of the patch.
  • Finger-test: this is a "provocation" test used to ascertain and demonstrate the role of latex proteins in triggering allergic symptoms. It is a second choice diagnostic test, used when previous tests are negative, but direct medical observation of skin lesions suggests a latex allergy. The patient should wear a latex glove finger on a wet hand, and a vinyl glove in the other hand. If, after 15 minutes, at least two wheals develop on the hand in contact with the latex, the test is considered positive.
  • Glove-test: it is performed if the finger test is negative. The glove test is very similar to the previous one: in this case, however, the patient will have to wear a whole latex glove in one hand for 30 minutes.

IN VITRO tests are performed to search for specific IgE for latex, directly in the subject's serum. In vitro tests to ascertain a suspicion of latex allergy are generally performed in those patients in whom in vivo tests are considered potentially dangerous (high risk of anaphylactic shock).

Latex allergy: therapies

Similar to nickel allergy, milk allergy and the vast majority of allergic reactions, there is also no cure for latex allergy. The only way to escape the symptoms of allergy is to avoid any contact with objects or substances containing latex.

But how should one act in case of occasional contact with latex objects?

More than "curative" therapy, it is more correct to speak of "palliative" treatment, which aims to alleviate symptoms, without removing the triggering cause. Especially when latex allergy manifests itself with some violence, the administration of specific drugs is the only life-saving remedy.

Less severe allergic latex reactions are treated with antihistamines, to be taken immediately after contact with latex. Corticosteroids (eg betamethasone), applied topically (ointments, gels, creams) or taken orally (eg desloratadine) significantly reduce allergy-induced inflammation.

In cases of extreme severity (anaphylaxis due to an allergy to latex) it is necessary to intervene promptly by injecting adrenaline and corticosteroids.

  • Let us remember once again: the only way to reduce the risk of latex allergy is to avoid any contact with objects made with latex.