Clinical and laboratory-based methods in the diagnosis of natural rubber latex allergy

Robert G. Hamilton, Edward L. Peterson, Dennis Randall Ownby

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

The accurate diagnosis of hypersensitivity to natural rubber latex is the initial step in the effective management of individuals with latex allergy and in ensuring the quality of epidemiologic studies. The diagnostic algorithm used in the evaluation of an individual with suspected latex allergy begins with a comprehensive clinical history during which risk factors (atopy, food allergies, hand dermatitis) and temporal relationships between symptoms and natural rubber product exposure are identified. If type IV hypersensitivity is suspected because of the delayed nature (hours to days) and confinement of symptoms to the skin-latex product contact areas, patch testing can be conducted to confirm the presence of activated T cells with specificity for rubber chemicals. If type I hypersensitivity is suspected because of ocular, upper and lower airway, and/or systemic symptoms that have rapid onset (minutes) after a definable latex exposure, a confirmatory skin or blood test for IgE antibody may be conducted to verify a state of sensitization within the individual. The definitive diagnosis would then be made only after consideration of the individual's clinical history and confirmatory in vivo and/or in vitro laboratory test results. If discordance remains between highly convincing latex-associated symptoms as identified in the history and repetitively negative confirmatory IgE antibody test results, then one of several types of in vivo provocation tests may be performed for adjudication. This overview examines the current state of the art in both in vivo and in vitro diagnostic methods for latex-specific IgE antibody detection in skin and blood. The performance, advantages, and limitations of each diagnostic method are compared.

Original languageEnglish (US)
JournalJournal of Allergy and Clinical Immunology
Volume110
Issue number2 SUPPL.
DOIs
StatePublished - Jan 1 2002

Fingerprint

Latex Hypersensitivity
Latex
Rubber
Immunoglobulin E
Antibodies
T-Cell Antigen Receptor Specificity
Immediate Hypersensitivity
Skin
Food Hypersensitivity
Delayed Hypersensitivity
Hematologic Tests
Dermatitis
Skin Tests
Epidemiologic Studies
Hypersensitivity
Hand
History

Keywords

  • Hypersensitivity
  • Latex-specific IgE antibody
  • Natural rubber latex
  • Skin tests

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Clinical and laboratory-based methods in the diagnosis of natural rubber latex allergy. / Hamilton, Robert G.; Peterson, Edward L.; Ownby, Dennis Randall.

In: Journal of Allergy and Clinical Immunology, Vol. 110, No. 2 SUPPL., 01.01.2002.

Research output: Contribution to journalArticle

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