Manifestation of intraoperative anaphylactic shock along with latex allergy:a pediatric case report.

Natural rubber latex (NRL) allergy is one of the most important causes of severe anaphylaxis during medical intervention. We report a pediatric case of latex allergy with multiple surgical histories. A 12-year-old girl developed anaphylactic shock during the pyeloplasty for ureteropelvic junction restenosis. Latex gloves or medications used during the surgery were suspected to be the cause of anaphylactic shock. We diagnosed her latex allergy on the basis of the results that serum latex-specific IgE, skin prick tests of extract from NRL gloves and recombinant Hev b 6.02 solution were positive. Basophil activation test of NRL gloves was also positive, supporting the diagnosis of immediate allergic reactions caused by NRL. It was speculated that a history of multiple surgeries in infancy became a trigger of sensitization to latex in this patient. Reoperation after the diagnosis of NRL allergy was carried out in a latex-free environment and completed without any allergic symptoms. It would be necessary to perform the pre-screening of latex allergy to prevent the onset of latex allergy especially in the patients with multiple surgical histories. J. Med. Invest. 65:292-295, August, 2018.

[1]  H. Mosbech,et al.  No evidence for contraindications to the use of propofol in adults allergic to egg, soy or peanut†. , 2016, British journal of anaesthesia.

[2]  A. Lucendo,et al.  Propofol administration is safe in adult eosinophilic esophagitis patients sensitized to egg, soy, or peanut , 2014, Allergy.

[3]  P. Demoly,et al.  Skin test concentrations for systemically administered drugs – an ENDA/EAACI Drug Allergy Interest Group position paper , 2013, Allergy.

[4]  G. Michalska-Krzanowska.  Anaphylactic reactions during anaesthesia and the perioperative period. , 2012, Anaesthesiology intensive therapy.

[5]  D. Ebo,et al.  Component‐resolved diagnosis from latex allergy by microarray , 2010, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[6]  J. Harper,et al.  BSACI guidelines for the investigation of suspected anaphylaxis during general anaesthesia , 2009, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[7]  D. Moneret-vautrin,et al.  Anaphylaxis to general anesthetics. , 2010, Chemical immunology and allergy.

[8]  R. Guéant-Rodriguez,et al.  Perioperative anaphylaxis. , 2010, The Medical clinics of North America.

[9]  K. Matsunaga,et al.  Hev B 6.02 is the most important allergen in health care workers sensitized occupationally by natural rubber latex gloves. , 2009, Allergology international : official journal of the Japanese Society of Allergology.

[10]  A. Vacca,et al.  Flow cytometric basophil activation test: detection of CD63 expression as a useful aid to diagnosis of latex allergy. , 2006, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[11]  A. Flahault,et al.  Natural rubber latex allergy among health care workers: a systematic review of the evidence. , 2006, The Journal of allergy and clinical immunology.

[12]  H. Rihs,et al.  Basophil Activation Test and specific IgE measurements using a panel of recombinant natural rubber latex allergens to determine the latex allergen sensitization profile in children , 2006, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[13]  G. Dagregorio,et al.  Allergic contact dermatitis from natural rubber latex in atopic dermatitis and the risk of later Type I allergy , 2005, Contact dermatitis.

[14]  A. Guttormsen,et al.  Anaphylaxis during Anesthesia in Norway: A 6-Year Single-center Follow-up Study , 2005, Anesthesiology.

[15]  D. Bernstein,et al.  In vivo sensitization to purified Hevea brasiliensis proteins in health care workers sensitized to natural rubber latex. , 2003, The Journal of allergy and clinical immunology.

[16]  S. Wagner,et al.  The latex-fruit syndrome. , 2002, Biochemical Society transactions.

[17]  A. Wade,et al.  Impact of repeated surgical procedures on the incidence and prevalence of latex allergy: a prospective study of 1263 children. , 2002, The Journal of pediatrics.

[18]  E. Krieg,et al.  Diagnostic performance of Food and Drug Administration-cleared serologic assays for natural rubber latex-specific IgE antibody. The Multi-Center Latex Skin Testing Study Task Force. , 1999, The Journal of allergy and clinical immunology.

[19]  E. Novembre,et al.  Prevalence of and risk factors for latex sensitization in patients with spina bifida. , 1998, The Journal of urology.

[20]  H. Yeang,et al.  The 14.6 kd rubber elongation factor (Hev b 1) and 24 kd (Hev b 3) rubber particle proteins are recognized by IgE from patients with spina bifida and latex allergy. , 1996, The Journal of allergy and clinical immunology.

[21]  B. Baldo,et al.  The incidence and clinical features of anaphylactic reactions during anaesthesia in Australia , 1993 .

[22]  B. Baldo,et al.  The incidence and clinical features of anaphylactic reactions during anesthesia in Australia. , 1993, Annales francaises d'anesthesie et de reanimation.

[23]  H. Mitsuhata,et al.  [The epidemiology and clinical features of anaphylactic and anaphylactoid reactions in the perioperative period in Japan]. , 1992, Masui. The Japanese journal of anesthesiology.