Factors that influence the presence of symptoms caused by latex allergy in children with spina bifida.

BACKGROUND

Some children with spina bifida who are sensitized to latex can have severe reactions, whereas others remain free of symptoms.

OBJECTIVE

Our aim was to study the differences between these two groups of patients.

MATERIAL AND

METHODS

In 110 consecutive children with spina bifida, we identified by means of skin prick tests and serum latex-specific IgE 32 patients sensitized to latex. In these 32 patients, data were collected for sex, age, personal and familial history of atopy, number of cystourethrograms and number of operations, history of intermittent bladder catheterization, serum levels of total IgE in units per milliliter and in z units, levels of latex-specific IgE, and results of skin prick tests.

RESULTS

Sixteen patients (50%) had clinical symptoms related to latex. These patients had significantly higher levels of serum specific IgE (32.8 +/- 30.7 U/ml vs. 12.8 +/- 16.5 U/ml), were more likely to have positive responses on skin tests (100% vs. 75%), had a higher number of operations (10.5 +/- 6.9 vs. 5.8 +/- 2.7), and were more likely to have a personal history of atopy (44% vs. 6%) in comparison with findings for patients who did not have symptoms (p < 0.05 in all cases). A multivariate logistic regression analysis identified the latter two factors as independent synergistic variables to predict symptoms.

CONCLUSIONS

The number of operations is the main risk factor for latex-related symptoms in sensitized children. Atopy seems to lower the threshold both for sensitization and for the presentation of clinical reactions.