Latex allergy
Latex allergy is an IgE-mediated hypersensitivity to natural rubber latex proteins causing contact urticaria, angioedema, and anaphylaxis, most often in health care workers and patients with repeated latex exposure such as spina bifida. Diagnosis uses latex-specific IgE and skin testing, and management is strict latex avoidance in a latex-safe environment with epinephrine for systemic reactions.
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What this article covers
- Overview
Definition: latex allergy is an IgE-mediated hypersensitivity to proteins in natural rubber latex, distinct from irritant or allergic contact dermatitis to rubber chemicals.
- Epidemiology
Occupational and repeated-exposure disease: health care and rubber-industry workers and heavily instrumented patients.
- Risk factors
Repeated latex exposure: health care work and multiple surgeries or catheterizations.
- Pathophysiology
IgE sensitization: repeated exposure to water-soluble latex proteins generates latex-specific IgE.
- Clinical features
Contact urticaria: wheals where latex touches skin (for example under gloves).
- Differential diagnosis
Allergic contact dermatitis to rubber accelerators: delayed type IV eczema to chemicals (thiurams, carbamates), not immediate IgE latex allergy.
- Diagnosis
Establish with a compatible history plus latex-specific IgE or skin testing: the diagnostic basis is a history of immediate reactions on latex exposure confirmed by a positive latex-specific serum…
- Management
First, treat systemic reactions as anaphylaxis: Epinephrine 0.3 to 0.5 mg IM into the anterolateral thigh, repeated every 5 to 15 minutes as needed.
- Complications
Perioperative or procedural anaphylaxis: the principal danger.
- Prognosis
Good with avoidance: a latex-safe environment prevents nearly all reactions.
- Prevention
Strict latex avoidance with non-latex gloves and latex-free devices in a latex-safe environment.
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Related articles
- Anaphylaxis
Anaphylaxis is an acute, potentially fatal systemic hypersensitivity reaction from massive mast cell and basophil mediator release, presenting within minutes as skin, respiratory, cardiovascular, and gastrointestinal involvement after allergen exposure. It is a clinical, treat-first diagnosis, and intramuscular epinephrine is the immediate life-saving therapy.
- Urticaria
Urticaria is transient, pruritic, edematous wheals from mast cell histamine release, classified by duration into acute (under 6 weeks) and chronic (6 weeks or longer, usually spontaneous/idiopathic). Diagnosis is clinical with minimal testing, and treatment is stepwise second-generation H1 antihistamines up-titrated as needed, adding omalizumab for refractory chronic disease.
- Angioedema
Angioedema is self-limited, non-pitting swelling of the deep dermis and submucosa that follows one of two mechanisms: mast cell (histamine) mediated, which occurs with urticaria and responds to epinephrine and antihistamines, or bradykinin mediated, which occurs without urticaria and does not. Distinguishing the two determines whether treatment is allergic therapy or bradykinin-targeted therapy, and airway involvement is the central danger.