SKIN AND SEROLOGIC TESTING IN THE DIAGNOSIS OF LATEX ALLERGY

Background: Later hypersensitivity is associated with occupational allergy, contact urticaria, rhinitis, asthma, and anaphylaxis. However, standardized sensitive and specific latex extract for skin prick or serologic testing is not available in the United States. Methods: We investigated the reliability of two latex extracts in 118 consecutive skin tests in patients with spina bifida, health care workers, and other patients with symptoms of latex allergy, and 10 control subjects. Results: Forty-two of 86 patients with spina bifida, 11 of 15 health care workers with symptoms of later allergy, 6 of 7 patients with symptoms of latex allergy, and 0 of 10 control subjects had demonstrable immediate wheal and flare responses to latex prick testing. In addition, 95 patients and 10 control subjects were tested concurrently for latex-specific IgE by ELISA. Of 55 patients with positive skin prick test results, 48 were reactive as determined by ELISA for IgE-specific latex antibody (sensitivity = 87%). Latex ELISA titers were significantly higher in patients with positive skin prick test results with a history of anaphylaxis to latex and in individuals without symptoms of latex allergy who had positive skin prick test results when compared with patients with negative skin prick test results. During the skin test procedure, nine patients had adverse reactions, including anaphylactic reactions in four. Conclusions: Skin prick and serum testing are reliable methods of diagnosing latex allergy. Serologic evaluation may be more desirable until allergen standardization is available.