Update: immediate and delayed hypersensitivity to natural rubber latex.

Natural rubber latex is an ingredient in many medical devices and consumer products. In some people however chemical additives induce T-cell mediated type IV delayed reactions while proteins occurring naturally in latex elicit antibody-mediated type I immediate reactions. It seems as though the prevalence of hypersensitivity to natural rubber latex is increasing. Delayed hypersensitivity may occur 4-48 hours after contact with the allergen and involve local redness swelling papules or edema as well as diffuse reactions. These reactions may lead to permanent tissue damage. Immediate hypersensitivity reactions are potentially fatal and may be likened to reactions in some from bee stings. Clinical manifestations do however vary depending upon a subjects susceptibility to the antigen and the conditions of exposure. More than 80 anaphylactic reactions to natural latex rubber have been reported in the literature many occurring intraoperatively Risk factors for developing latex hypersensitivity and diagnostic options are reviewed. Allergen avoidance being the only reliable management strategy the authors discuss factors which can affect the levels of both type I and type II allergens in products.