English Abstract

Latex Allergy
Pathophysiology and Diagnosis/Treatment

Department of Pediatrics, International University of Health and welfare Mita Hospital, Minato-ku, Tokyo, Japan
Nippon Gomu Kyokaishi,(2015),88(9),351-357 General Review in Japanese

Latex allergy (LA) is the allergic reaction triggered by proteins containing in natural rubber latex (NRL) or chemicals in NRL products. The pathophysiology of LA is divided into the immediate type (type I) allergy and the delayed type (type IV) allergy. Majority of LA is the allergic reactions mediated by specific IgE (sIgE) antibodies produced by contacts and exposures to NRL by inhaling the powder in the environments when wearing or removing the gloves made from NRL.
Recently, the frequency of immediate type allergy reaction is decreasing, but the delayed type allergy reaction caused by chemical substances added during glove manufacturing is increasing. Allergic contact dermatitis (ACD) caused by thiuram compound (a vulcanization accelerator), is increasing and it is clear that 80% of ACD cases in health care workers are sensitized to this substance.
For Diagnosis of LA, a detailed patient interview is the most important and sensitization to NRL is confirmed by a blood test or skin test to show an existence of sIgE antibodies to NRL. Also a positive provocation is useful for diagnosis.
Treatment for type I reactions is histamine H1 receptor antagonist or systemic steroids. However, in severe case such as anaphylactic shock, it is necessary to administer adrenaline. In case of type IV reactions, it is important to take local steroids or use moisturizing agents in addition to replace gloves free of vulcanization accelerator.

Keywords: Latex Allergy, Allergic Contact Dermatitis, Vulcanization Accelerator, Latex-fruit Syndrome