As with other allergic-type reactions, exposure to the allergen produces an antigenic reaction. After initial exposure to an antigen, the immune system responds by producing specific immunoglobulin (Ig) antibodies in the lymph nodes. Helper T cells enhance the process. These antibodies (IgE) then bind to membrane receptors located on the mast cells and basophils. When the body reencounters the antigen, the IgE antibodies, or cross-linked IgE receptors, recognize the antigen as foreign. This activates a series of cellular reactions that, if left unchecked, will lead to rapid vascular collapse and, ultimately, hemorrhage, disseminated intravascular coagulation, and cardiopulmonary arrest.

Latex allergy can produce myriad symptoms, including generalized itching (on the hands and arms, for example); itchy, watery, or burning eyes; sneezing and coughing (hay fever-type symptoms); rash; hives; bronchial asthma, scratchy throat, or difficulty breathing; edema of the face, hands, or neck; and anaphylaxis.

For people with latex allergy, latex becomes a hazard when the protein in latex comes in direct contact with mucous membranes or is inhaled, which happens when powdered latex surgical gloves are used. People with asthma are at greater risk for developing symptoms from airborne latex. Skin irritations and excoriations can result from skin contact, whereas full-blown anaphylaxis may develop from inhaled latex or from receiving an I.V. containing latex products. (See “Anaphylaxis,” page 42.)

Certain groups of people are at increased risk for developing latex allergy. These groups include people who have had or will undergo multiple surgical procedures (especially those with a history of spina bifida), health care workers (especially those in the emergency department and operating room), workers who manufacture latex and latex-containing products, and people with a genetic predisposition to latex allergy.

People who are allergic to certain cross-reactive foods, including apricots, cherries, grapes, kiwis, passion fruit, bananas, avocados, chestnuts, tomatoes, and peaches, may also be allergic to latex. Exposure to latex elicits an allergic response similar to that elicited by these foods.

The diagnosis of latex allergy is based on the patient’s history and physical examination. Laboratory testing should be performed to confirm or eliminate the diagnosis. Skin testing can be done, but the Alastat test, Hycor assay, and Pharmacia
Cap test are the only available blood tests approved by the Food and Drug Administration. Some laboratories may perform an enzyme-linked immunosorbent assay.