Latex hypersensitivity T78.4

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

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Definition
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Allergy or intolerance reaction to latex or additives (vulcanizers, accelerators, antioxidants) of the processing method In case of allergy mostly IgE-mediated immediate reaction, rarely type IV reactions.

Occurrence/Epidemiology
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After contact with surgical, examination, household gloves, plasters, respiratory masks, urine bags, intestinal tubes, etc. Overall increasing incidence. Risk group: Medical staff, atopic persons, children with spina bifida or urinary tract malformations.

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Etiopathogenesis
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The triggering of type I, type IV, pseudoallergic and irritant eczematous reactions by handling the ingredients contained in the respective product is described:
  • Type IV allergies (allergic contact eczema): accelerators (thiurams, thiocarbamates, benzothiazoles, thioureas), antioxidants, vulcanizers, dye additives, latex, epichlorohydrin (?).
  • Type I allergies (immunological contact urticaria): latex, corn starch powder (?).
  • Pseudoallergic reactions (non-immunological contact urticaria): corn starch powder (sorbic acid?).
  • Irritative eczematous skin reactions: occlusion effects (maceration), glove powder, disinfectant.

Clinical features
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S.u. eczema, contact eczema; contact urticaria; rhinitis allergica; neoprene allergy; anaphylaxis (allergy, type I reaction).

Diagnosis
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Prick test, intradermal test, scratch test, epicutaneous test, friction test, provocation test, RAST.

Therapy
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Avoid the allergen by wearing synthetic rubber gloves, e.g. made of PVC, polyethylene, nitrile rubber, styrene-ethylene-butylene-styrene or styrene-butadiene and if possible accelerator-free, non-powdered gloves .

Tables
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Reactions to latex gloves

Diseases

Trigger

Allergic reactions

Type IV allergies (allergic contact eczema)

Accelerators (thiurams, thiocarbamates, benzothiazoles, thioureas), antioxidants, vulcanizers, dye additives, latex, epichlorohydrin (?)

Type I allergies (immunological contact urticaria)

Latex, corn starch powder (?)

Pseudoallergic reactions

non-immunological contact urticaria

Corn starch powder (sorbic acid?), pressure and sweating urticaria

irritant eczematous skin reactions

occlusion effects (maceration), glove powder, disinfectant


Examination gloves

Manufacturer/distribution

Glove

Material

Accelerators according to manufacturer specifications

Powder

Thiurame

Dithiocarbamates

Benzothiazoles

Thioureas

Ansell Medical

Examtex Vinyl

PVC

-

-

-

-

+

Syndication

PVC

-

-

-

-

-

Nitratouch

NK

-

+

+

-

-

Ansell Edmont

Touch N Tuff

NK

-

+

+

-

-

Beiersdorf

Glovex vinyl

PVC

-

-

-

-

+

Glovex neoderm

SEBS

-

-

-

-

+

Dispex (sterile)

PET

-

-

-

-

+

Dispex (unsterile)

PET

-

-

-

-

+

Hartmann

Peha-soft-vinyl

PVC

-

-

-

-

-

Peha-fol

PET

-

-

-

-

-

Johnson & Johnson

Ethiparat (sterile)

PETMA

-

-

-

-

+

Ethiparat (non-sterile)

PETMA

-

-

-

-

+

OP gloves

Allegiance

Duraprene

NEOP

-

+

-

-

+

Duraprene Powderfree

NEOP

-

+

-

-

Johnson & Johnson

Allergard

SEBS

-

-

-

-

+

Hartmann

Peha-taft-syntex

SBSI

-

-

-

-

+

Literature
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  1. Ahmed DD et al (2003) Occupational allergies caused by latex. Immunol Allergy Clin North Am 23: 205-219
  2. Bonnekoh B, Merk HF (1992) Occupational dermatological relevance of a generalized latex anaphylaxis induced by inhalation in the medical field of activity. Z Hautkr 67: 532-534
  3. Chowdhury MM et al (2003) Natural rubber latex allergy in a health-care population in Wales. Br J Dermatol 148: 737-740
  4. Ebo DG et al (2004) Sensitization to cross-reactive carbohydrate determinants and the ubiquitous protein profilin: mimickers of allergy. Clin Exp Allergy 34: 137-144
  5. Ehl W et al (1988) Latex allergies as IgE-mediated immediate reactions. Allergology 5:182-187
  6. Fabro L et al (1989) Anaphylactic reaction to latex, an instant type allergen of increasing importance. dermatologist 40: 208-211
  7. Heese A et al (1989) Allergies and intolerance reactions to latex gloves in the medical field. Dt Ärztebl 46: 41-46
  8. Roest MA et al (2003) Insulin injection site reactions associated with type I latex allergy. N Engl J Med 348: 265-266
  9. Zeiss CR et al (2003) Latex hypersensitivity in Department of Veterans Affairs health care workers: glove use, symptoms, and sensitization. Ann Allergy Asthma Immunol 91: 539-545

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Incoming links (1)

Tomato allergy;

Outgoing links (14)

Allergic rhinitis; Allergy (overview); Contact dermatitis (overview); Contact urticaria; Epicutaneous test; Friction test; Intolerance reaction; Intracutaneous test; Latex allergy; Neoprene allergy; ... Show all

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

Authors

Last updated on: 29.10.2020

Author: Prof. Dr. med. Peter Altmeyer Prof. Dr. med. Peter Altmeyer

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