Latex Allergy

Natural rubber latex comes from the milky sap of the rubber tree (Hevea brasiliensis) found in Africa and Southeast Asia. Latex is used in a wide variety of products ranging from tires to balloons to medical gloves. Surprisingly, latex paint contains no natural rubber latex protein. Instead, paint contains synthetic latex which does not cause allergic reactions.

In the 1980’s, latex allergy became a far greater problem as healthcare workers began to wear latex gloves to prevent the spread of blood borne illnesses. In latex allergy, the immune system produces a type of antibody called Immunoglobulin E (IgE) that recognizes the latex protein. These IgE antibodies travel to and coat cells called mast cells. Mast cells reside everywhere the body comes in contact with the environment (skin, nose, lungs, gut) and contain chemicals such as histamine.

On exposure to latex, the latex protein binds to the IgE and the mast cell releases histamine leading to the symptoms of an allergic reaction. People at increased risk of developing latex allergy include heath care workers and spina bifida patients. (paragraph) Other chemicals used to make latex containing products, such as gloves, can also trigger a delayed type allergic reaction. In this type of reaction, a blistering rash occurs 12-48 hours after exposure only where the skin came in contact with the latex.

Symptoms

In IgE-mediated allergic reactions to latex, exposure leads to a release of histamine from mast cells. This in turn leads to symptoms of hives (urticaria), swelling (angioedema), itching, and flushing. The latex protein can become airborne, especially when it becomes attached to the cornstarch powder used in powdered gloves. Inhaling this airborne latex can trigger sneezing, itchy watery eyes, cough, wheeze and shortness of breath. In particulary sensitive people or with heavy exposure, allergic reactions to latex can be life threatening. Intersetingly, latex allergic patients may also note allergic symptoms on exposure to certain foods such as avacodo, banana, kiwi, chestnut, white potato, tomato, bell pepper, and peach. Symptoms are typically mild with itching of the mouth but can be severe at times.(paragragh) Delayed contact allergic reactions to latex and chemicals used in processing latex, cause an irritated rash similar to a poison ivy rash. Symptoms are aggravating but not life threatening and do not increase a person’s risk of developing an IgE-mediated allergic reaction.

Diagnosis

Diagnosing latex allergy relies heavily on a detailed history exploring symptoms and possible exposure to latex. In addition, a history of allergic reactions to cross-reactive foods can be very helpful. Skin prick testing using standardized latex allergens is used in Europe, but is not available in the United States. The allergist may perform skin testing to a latex extract made in the office using latex gloves. In addition, skin testing to cross-reactive foods may be of benefit. Given the lack of standardized latex extract for skin testing, a negative skin test may need to be confirmed by a blood based allergy test (commonly called RAST testing) to latex. Finally, in certain circumstances, a challenge test may be recommended to confirm latex allergy. The diagnosis of delayed, contact latex allergy is made utilizing allergen patch testing. In patch testing, a standard panel of chemicals commonly used in cosmetics and everyday products, including latex and chemicals used in processing latex, are placed on the back for 48-72 hours. A positive test results in a characteristic red, raised and at times blistering rash.

Treatment

Unfortunately, there is no cure for latex allergy. The mainstay of treatment is avoidance of latex and latex containing products. Identifying hidden sources of latex and latex containing products is key. For mild allergic symptoms, an antihistamine can be beneficial. For more severe reactions, epinephrine is the treatment of choice. An emergency alert bracelet should be worn by those with more severe symptoms. (paragraph) For contact sensitivity, avoidance is again the mainstay of treatment. Once the chemical triggers have been identified by patch testing, it is possible to identify what products to avoid and what alternative products are safe to use. If symptoms recur, antihistamines can alleviate itching and steroid creams can speed resolution of the rash.

How We Can Help

Allergy Partners physicians are board certified experts in the diagnosis, treatment, and management of allergic diseases, including latex allergy. If you are having symptoms suggestive of latex allergy, your Allergy Partners physician will take a detailed history, perform a physical exam, and order appropriate testing to confirm the diagnosis of latex allergy or contact sensitivity. Working together, you and your Allergy Partners physician will develop a comprehensive and personalized treatment plan.

 
     
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