1/50. Latex allergy in an orthognathic patient and implications for clinical management.A 19-year-old girl with mild asthma had had 16 months of orthodontic treatment as part of the joint orthodontic/orthognathic approach to her 9.5 mm overjet. At the time of banding her second molars she developed latex protein allergy as a reaction to the operator's non-sterile powdered latex gloves. She also gave a history of allergy to other substances as well as of eczema. The patient was confirmed as allergic to latex protein by radioallergosorbent test (RAST) for IgE, requiring precautions be taken during further orthodontic procedures as well as during the subsequent orthognathic surgery for the underlying Class II skeletal pattern.- - - - - - - - - - ranking = 1keywords = allergy (Clic here for more details about this article) |
2/50. Latex allergy in atopic children.The incidence of positive circulating specific immunoglobulin e (IgE) antibodies to latex and evidence of clinical latex sensitivity appears to be increasing since its first description in 1979. Although heightened medical awareness may be a factor, exposure to latex products, particularly rubber gloves, has increased since the discovery of the human immunodeficiency virus (hiv). Atopic individuals are at greater risk of developing latex sensitivity. We identified seven children with atopic eczema who were known to have clinically significant latex allergy and examined the relationship of prior exposure to latex gloves. All children had significant serum levels of specific IgE to latex. Before developing clinical symptoms of latex allergy, all had been exposed to latex in the form of gloves during either inpatient or outpatient treatments of their skin. Exposure of atopic individuals to latex gloves could be a major risk factor for sensitization and could increase the incidence of serious reactions.- - - - - - - - - - ranking = 1keywords = allergy (Clic here for more details about this article) |
3/50. Latex anaphylaxis causing heart block: role of ranitidine.PURPOSE: Treatment with H2 receptor antagonists may cause the heart to be more susceptible to atrioventricular conduction delay when exposed to an overwhelming insult by histamine released during an anaphylactic reaction. We present the case of a woman, pretreated with ranitidine, who developed 3:1 heart block secondary to latex anaphylaxis. We propose that H2 antagonist premedication alone in patients susceptible to anaphylaxis increases their risk of heart block. CLINICAL FEATURES: A 38 yr old obese woman with cervical cancer presented for a radical hysterectomy. Systems review yielded a history of sleep apnea, orthopnea, gastroesophageal reflux, and sciatica. Medications included preoperative ranitidine, 150 mg. There was no history of atopy or allergy. Following general anesthesia induction, at the onset of the surgical procedure the patient developed a severe anaphylactic reaction which was heralded by the onset of 3:1 heart block, with decreases in SpO2, P(ET)CO2 and a decrease in systolic blood pressure to 45 mmHg. This was diagnosed as a possible latex reaction and treated using epinephrine boluses and infusion, fluids, 50 mg diphenhydramine, 50 mg ranitidine and 100 mg hydrocortisone. Following a 48 hr stay in the ICU the patient made an uneventful recovery. Allergy testing with intradermal latex injection and increased plasma tryptase levels confirmed a latex anaphylaxis. CONCLUSION: The use of H2 antagonists alone as a prophylaxis for gastroesophageal reflux may increase the risk of heart block in patients who develop anaphylaxis.- - - - - - - - - - ranking = 0.16666666666667keywords = allergy (Clic here for more details about this article) |
4/50. Glucocorticosteroid treatment for cerebrospinal fluid eosinophilia in a patient with ventriculoperitonial shunt.BACKGROUND: cerebrospinal fluid (CSF) eosinophilia commonly occurs in patients with ventriculoperitoneal (VP) shunts and is associated with shunt complications such as obstruction or infection. Glucocorticosteroids (GCS) are effective in reducing eosinophilia and eosinophils in skin, nasal mucosa, and airway epithelium. Effects of GCS on CSF eosinophils has not been reported. OBJECTIVE: To demonstrate glucocorticosteroid effects on the CSF eosinophil levels and to propose that GCS may be used as a therapeutic agent for CSF eosinophilia. RESULT: A case report of a patient with congenital hydrocephalus and a VP shunt developed CSF eosinophilia associated with latex allergy and shunt malfunction. Daily treatment with 2 mg/kg of methylprednisolone was associated with reduced peripheral eosinophilia and slightly reduced CSF eosinophil counts. pulse methylprednisolone, 15 mg/kg, was associated with complete reduction of CSF eosinophils and prolonged VP shunt survival. CONCLUSION: Systemic glucocorticosteroids effectively reduce CSF eosinophils. Glucocorticosteroids may be beneficial for treatment of CSF eosinophilia associated with VP shunt malfunction.- - - - - - - - - - ranking = 0.16666666666667keywords = allergy (Clic here for more details about this article) |
5/50. Allergy to local anaesthetic: the importance of thorough investigation.A case report is presented which highlights the importance of a good history in arriving at the correct diagnosis in cases where allergy to local anaesthetic is suspected. Management of the patient is discussed and the topic of 'adverse reaction' briefly reviewed.- - - - - - - - - - ranking = 0.16666666666667keywords = allergy (Clic here for more details about this article) |
6/50. Current perspectives on the perioperative management of the latex-allergic patient.The increasing incidence of latex allergy necessitates thorough preanesthetic screening for risk factors, which will be delineated in this article, that are associated with latex allergy. The pathophysiology, epidemiology, and testing procedures for latex allergy will be reviewed. This case report will illustrate the management of a patient who was found to be latex-sensitive during surgery and the management of intraoperative anaphylaxis is provided. Safe perioperative care can be provided for latex-sensitive patients if latex avoidance techniques are used consistently.- - - - - - - - - - ranking = 0.5keywords = allergy (Clic here for more details about this article) |
7/50. Latex allergy--implications for Irish patients and healthcare workers.A 34-year-old lady presented with an exacerbation of her atopic dermatitis. She also gave a history of angioedema during labour. Type I latex hypersensitivity was confirmed by serological and epicutaneous testing. Virtually unrecognised until the 1980s, latex hypersensitivity is now being reported more and more frequently, particularly in spina bifida patients, atopics and healthcare personnel. The importance of this problem for patients and healthcare personnel is discussed.- - - - - - - - - - ranking = 0.66666666666667keywords = allergy (Clic here for more details about this article) |
8/50. Latex allergy. An orthopaedic case presentation and considerations in patient care.Latex allergy has become a challenging phenomenon in health care delivery for the last several years given the numerous products containing latex. The number of individuals with latex allergy has grown dramatically since the institution of standard precautions issued by the Centers for disease Control and Prevention (CDC) in 1987 in response to the AIDS epidemic. The allergic reaction to latex ranges from a minor skin rash to anaphylactic shock. Preventing exposure to latex is the key to managing and preventing this allergy. Providing a safe environment for patients with latex allergy is the responsibility of all health care professionals. Identification of patients with such an allergy or those at risk is the initial step toward providing a safe environment. Care givers must have a clear understanding of the routes of exposure, effective prevention modalities, the types of allergic reactions that may be manifested by latex sensitivities, the signs and symptoms of allergic reactions, and the treatment options related to the reactions. An orthopaedic case presentation represents a multidisciplinary team approach that successfully managed a patient undergoing a total knee arthroplasty.- - - - - - - - - - ranking = 1.5keywords = allergy (Clic here for more details about this article) |
9/50. Latex allergy: a nursing update.Latex allergy emerged in the 1990's as a significant and challenging public health concern for patients as well as healthcare workers. This article provides a review of this complex health care challenge. Understanding latex allergy production and sources of exposure will provide a background to explore the immunological implications of this exposure risk. Diagnostic and treatment measures are reviewed. The focus of this article is to increase awareness and encourage prevention of this growing health concern.- - - - - - - - - - ranking = 1keywords = allergy (Clic here for more details about this article) |
10/50. Latex allergy: an update for the otolaryngologist.OBJECTIVE: To describe the clinical manifestations of latex allergy in otolaryngology patients. DESIGN: Descriptive case series. SETTING: Tertiary academic otolaryngology practice. patients: otolaryngology patients with documented allergic reactions to latex during surgery and confirmatory laboratory test results for latex allergy. MAIN OUTCOME MEASURES: Clinical description of latex reactions; identification of risk factors for latex allergy. RESULTS: We describe 3 patients, 2 children and 1 young adult, with severe latex allergy manifested by intraoperative cardiorespiratory changes and confirmed by positive latex-specific IgE test results. A 9-year-old boy with a tracheotomy and a history of multiple procedures for laryngeal stenosis developed a rash and unexplained bronchospasm during an open laryngeal procedure. Surgery was aborted, and subsequent surgery was performed uneventfully 4 weeks later using a latex-safe environment. A 13-year-old boy with recurrent respiratory papillomatosis and a ventriculoperitoneal shunt had sudden unexplained arterial oxygen desaturation and a rash during laser endoscopy. He was then treated successfully using latex-safe protocols. A 23-year-old man with a parotid malignancy developed unexplained hypotension and ventilatory difficulties in the operating room during preparation for surgery. He responded to medical treatment for anaphylaxis. CONCLUSION: The otolaryngologist should share in the increased awareness of latex allergy. Our patients who have had multiple surgical procedures or who are exposed to latex on a long-term basis may be at increased risk. Latex allergy should be considered when unexplained cardiorespiratory compromise occurs during surgery.- - - - - - - - - - ranking = 1.6666666666667keywords = allergy (Clic here for more details about this article) |
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