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Correspondence  |   October 2011
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Author Affiliations & Notes
  • Gaetano Draisci, M.D.
    *
  • *Catholic University of Sacred Heart, Rome, Italy.
Article Information
Correspondence
Correspondence   |   October 2011
In Reply
Anesthesiology 10 2011, Vol.115, 903-904. doi:10.1097/ALN.0b013e31822ecb52
Anesthesiology 10 2011, Vol.115, 903-904. doi:10.1097/ALN.0b013e31822ecb52
We appreciate Dr. Abouleish's deep attention in revising our article1 and we thank him for his comments. To investigate a possible history of allergy in our patients, we designed our questionnaire according to data in the literature.2  5 All risk factors (multiple surgical procedures, high-risk work, atopy, cross-reacting fruits/vegetables, previous history of allergy) associated with latex sensitization were analyzed. The same factors were recently described by Sampathi and Lerman as risk factors for developing latex allergy in children.6 In table 1, we reported the statistical differences between pregnant and nonpregnant patients. Even if the two groups showed different frequencies or means for all variables, those differences were not significant (P  > 0.05), that is, the pregnant and nonpregnant groups were omogenous. In contrast with previous data reported by Chen et al.  ,7 we found no significant correlations between accepted risk factors and latex sensitization in our study.
We also thank Dr. Weiniger for the interest in our work. In our data, the two patients who experienced an adverse reaction previously experienced allergic disease and hand hitching after the use of rubber gloves. In studies performed before surgery, both patients revealed a sensitization to latex, presenting with a latex immunoglobulin E serum concentration of 100 kilo units/l and 5.33 kilo units/l, respectively. After adverse reaction, skin-prick and intradermal tests were performed to detect latex allergy: both tests were positive. Oxytocin and other drugs were administered and tested, and other drug allergies were excluded. After pregnancy, high-latex immunoglobulin E serum concentration was reported, and the patients were managed with desensitizing treatment.
We agree with Weiniger's statement that increased sensitization to latex in pregnant patients could be a potential danger in the labor and delivery suite. Conversion to a latex-free hospital environment could be possible, but in our opinion additional investigations in larger groups of patients are needed to better define this potential high risk.
References
Draisci G, Zanfini BA, Nucera E, Catarci S, Sangregorio R, Schiavino D, Mannocci A, Patriarca G: Latex sensitization: A special risk for the obstetric population? ANESTHESIOLOGY 2011; 114:565–9
Rendeli C, Nucera E, Ausili E, Tabacco F, Roncallo C, Pollastrini E, Scorzoni M, Schiavino D, Caldarelli M, Pietrini D, Patriarca G: Latex sensitisation and allergy in children with myelomeningocele. Childs Nerv Syst 2006; 22:28–32
Suli C, Parziale M, Lorini M, De Silva E, Miadonna A, Tedeschi A: Prevalence and risk factors for latex allergy: A cross sectional study on health-care workers of an Italian hospital. J Investig Allergol Clin Immunol 2004; 14:64–9
Gentili A, Ricci G, Di Lorenzo F, Pigna A, Tonini C, Baroncini S: Latex allergy in pediatric age: An interdisciplinary perioperative management and case reports. Minerva Anestesiol 2001; 67:29–40
Lavaud F: Cross-sensitization between latex and fruits. J Allergy Clin Immunol 1996; 98:473–4
Sampathi V, Lerman J: Case scenario: Perioperative latex allergy in children. ANESTHESIOLOGY 2011; 114:673–80
Chen FC, von Dehn D, Büscher U, Dudenhausen JW, Niggemann B: Atopy, the use of condoms, and a history of cesarean delivery: Potential predisposing factors for latex sensitization in pregnant women. Am J Obstet Gynecol 1999; 181:1461–4