Dehlink E, Prandstetter C, Eiwegger T, Putschogl B, Urbanek R, Szepfalusi Z. Allergy. 2004;59:734–738
Purpose of the Study.
To assess the prevalence of latex sensitization and identify risk factors for latex sensitization among children with chronic renal failure.
Ninety-three patients (44 boys and 49 girls; median age: 10.5 ± 6.0 years) with chronic renal failure who presented to the University of Vienna Children’s Hospital Nephrology Clinic between 1997 and 2000.
Latex sensitization was assessed by a questionnaire-based history and measurement of total and latex-specific serum IgE by solid-phase immunoassay. Patients and parents were queried regarding the etiology of renal failure, age at onset, number of renal transplantations, surgical procedures, hemodialysis, clinical symptoms with latex exposure, personal and family history of allergy, and history of pacifier use. Patient responses were compared with medical histories and were consistent. Patients were designated as latex sensitized if their latex-specific serum IgE was ≥0.35 kilounits of allergen-specific IgE per liter (kUA/L). Neither skin-prick testing nor provocation testing was performed.
Of the 93 patients enrolled, 10 (10.8%) were found to have latex-specific IgE levels (0.35–9.44 kUA/L.) Of those, only 1 patient reported clinical symptoms on latex exposure compared with 4 patients with no demonstrable latex-specific IgE. No reactions to latex were reported to occur during medical care. A personal or family history of allergy, a greater number of urogenital surgeries, and hemodialysis were reported more frequently in latex-sensitized children. Gender, age at enrollment, age at first urogenital surgery, renal transplantation, and the use of pacifiers did not differ between latex-sensitized and -nonsensitized children.
The prevalence of latex sensitization among children with chronic renal failure is greater than that previously reported for the general pediatric population (10 of 93 vs 8 of 1175 in an unselected pediatric population). Eight of the 10 sensitized patients in this study had renal disease diagnosed within the first year of life and therefore had early and repeated exposures to latex. The small sample size prevented detection of significant associations with any determinant of renal disease or definite risk factor for sensitization.
Atopy and repeated exposure to latex allergen have been previously associated with sensitization to latex. Children with chronic renal failure are frequently exposed to latex and therefore are likely at increased risk. A larger study population would be required to further characterize this increased risk. This study raises interesting questions regarding the impact of both timing and cumulative amount of latex exposure for all children with chronic illnesses.