Type I allergy: Clinical expression
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| In 1992, about 1600 cases of allergy or anaphylactic reactions, including 16 deaths, were reported to the Food and Drug Administration (FDA).
The type of allergenic response depends on the allergen penetration route. |
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Direct contact
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| Direct contact with latex gloves may induce localized urticaria. |
| However, the latex allergens released by sweat may penetrate the skin via the follicles and then spread throughout the body in the blood flow. |
| For that reason, generalized urticaria and/or anaphylactic shock, potentially fatal, may be observed. |
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Latex protein inhalation
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| Latex protein inhalation gives rise to allergic reactions such as rhinoconjunctivitis, asthma and anaphylactic shock. The allergenic proteins bound to the powder spread in the ambient air when gloves are donned or removed.
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| ( see Role of the powder) |
| The various urticaria syndromes are summarized in the table below. |
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| Stage | | Clinical Picture (based on Von Krogh G, Maibach HI) | |
| >90% | | | |
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- Localized urticaria (contact zone)
- Urticaria exceeding the contact zone: regional, generalized, with labial and palpebralœ angioedema…
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| 20 to50% | | | |
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| | Urticaria with mucosal oedema: | |
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- respiratory: rhinoconjunctivitis, asthma
- laryngeal: orolaryngeal symptoms
- gastrointestinal: gastrointestinal symptoms
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| 5 to 10% | | | |
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| | Urticaria with anaphylactic shock | |
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Asthma
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| Asthma is one of the most feared complications of latex glove use with anaphylactic shock. If professional exposure is daily, the discomfort caused may be almost constant and only improves during vacations. Re-exposure is associated with recurrence. When sensitization is related to the use of latex gloves, contact urticaria is very frequently associated or precedes or follows the respiratory signs. |
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Anaphylactic shock
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| Described with latex use at the start of the 1980s, anaphylactic shock mainly occurs during surgical procedures and intravenous contacts.
It constitutes: ( Laxenaire, 1996 ). |
- the leading cause of per-operative anaphylactic shock in children
- the second cause, after neuromuscular blocking agents, of anaphylactic shock in adults (0.5% in 1989 and 19% in 1994).
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| Potentially fatal, anaphylactic shock associates a fall in blood pressure and cardiorespiratory arrest (15 to 20 minutes post-anaesthesia induction). |
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