Dikkat! lateks allerjisi

Lateks bir kauçuk ürünüdür ve lateks proteinleri allerjik tepkimelere yol açabilmektedir. Allerjik yanıtlar basit deri döküntülerinden ölümle sonuçlanabilen anafilaktik şok gibi acil müdahale gerektiren durumlara dek değişebilir. Bu çalışmanın amacı çocuk cerrahisi uygulamalarında karşılaşılabilecek lateks allerjisi riskini tartışmaktır. Altı yaşında bir kız hasta tiroglossal kist ile getirildi. Astım bronşiti olan hastada, kan IgE düzeyi yüksekliği nedeniyle bir yıl önce yapılan testlerde lateks allerjisi saptanmış. Hastaya ameliyattan önce bir hafta ağızdan antihistaminik verildi. Ameliyathane ortamındaki tüm malzemenin latekssiz olması sağlandı. Ameliyata başlarken metilprednizolon, klorfeniramin, ranitidine verildi ve Sistrunk ameliyatı yapıldı. Ameliyat sırasında ve sonrasında allerjik tepkime gözlenmedi. Hastaneye sık yatan ve özellikle cerrahi müdahale geçiren çocuklar daha önce atak geçirmemiş olsa da lateks allerjisi riski altındadır. Cilt testi negatif bulunsa dahi lateks allerjisi her zaman gelişebilir. Tıbbi ortamlarda lateks allerjisi olasılığının bilincinde olmak, yüksek riskli kişilerde allerji gelişimini önlemek ve allerjisi olduğu bilinen hastalarda tepkimelerin şiddetini azaltmak tedavide esastır. Lateks allerjisinin kesin tedavisi olmadığı unutulmamalıdır!

Attention! latex allergy

Latex is a rubber and Latex proteins cause allergic reactions. Allergic responses can range from minor skin irritations to reactions requiring emergency treatment to prevent death. The aim of this report is to discuss the potential risk of Latex allergy in the field of pediatric surgery / pediatric surgical practice. A six year old girl was admitted with a throglossal cyst. A year ago she was diagnosed to have bronchial asthma and due to her high blood IgE levels a skin-pick test was performed that verified Latex allergy. Before the operation antihistaminic medication was used orally for seven days and metilprednisolone, chlorpheniramine, ranitidine were given preoperatively. Sistrunk operation was performed at surgery. Postoperative follow-up was uneventful and no allergic reactions were noted. Children who have had multiple hospitalizations and surgical procedures are at particularly high risk for developing allergy to Latex. Also even having no previous reactions but having spina bifida, genitourinary anomalies and documented reactions to iv drains are high-risk groups for Latex allergy. Latex allergy can develop at any time even after a test shows no sensitivity. Awareness of this problem is crucial in the medical environment and avoidance is the key to prevent from development of Latex allergy in high-risk individuals and lessening the degree of reaction in those already allergic patients. Don't forget! There is no cure for Latex allergy.

Kaynakça

1. Akcakaya N, Kulak K, Hassanzadeh A, Camcioglu Y, Cokugras H. Latex allergy: the incidence among Turkish children with atopic disease and with neural tube defects. Allergol Immunopathol 27:141,1999

2. Cremer R, Kleine-Diepenbruck U, Hering F, Holschneider AM.Reduction of Latex sensitisation in spina bifida patients by a primary prophylaxis programme (five years experience). Eur J Pediatr Surg 12:19, 2002

3. Degenhardt P, Golla S, Wahn F, Niggemann B. Latex allergy in pediatric surgery is dependent on repeated operations in the first year of life. J Pediatr Surg 36:1535, 2001

4. Gunther KP, Nelitz M, Parsch K, Puhl W. Allergic reactions to Latex in myelodysplasia: a review of the literature. J Pediatr Orthop B 9:180, 2000

5. Hollnberger H, Gruber E, Frank B. Severe anaphylactic shock without exanthema in a case of unknown Latex allergy and review of the literature. Paediatr Anaesth 12:544, 2002

6. Mazon A, Nieto A, Estornell F, Nieto A, Reig C, Garcia-Ibarra F. Factors that influence the presence of symptoms caused by Latex allergy in children with spina bifida. J Allergy Clin Immunol 99:600, 1997

7. Meric F, Teitelbaum DH, Geiger JD, Harmon CM, Groner JI. Latex sensitization in general pediatric surgical patients: a call for increased screening of patients. J Pediatr Surg 33:1108, 1998

8. Michael T, Niggemann B, Moers A, Seidel U, Wahn U, Scheffner D. Risk factors for Latex allergy in patients with spina bifida. Clin Exp Allergy 26:934, 1996

9. Moneret-Vautrin DA, Mata E, Gueant JL, Turgeman D, Laxenaire MC. High risk of anaphylactic shock during surgery for spina bifida. Lancet 7:865, 1990

10. Niggemann B, Breiteneder H. Latex allergy in children. Int Arch Allergy Immunol 121:98, 2000

11. Szepfalusi Z, Seidl R, Bernert G, Dietrich W, Spitzauer S, Urbanek R. Latex sensitization in spina bifida appears disease-associated. J Pediatr 134:344, 1999

12. Tangsinmankong N, Nelson RP Jr, Good RA. Glucocorticosteroid treatment for cerebrospinal fluid eosinophilia in a patient with ventriculoperitonial shunt. Ann Allergy Asthma Immunol 83:341, 1999

13. Yassin MS, Sanyurah S, Lierl MB, Fischer TJ, Oppenheimer S, Cross J, O'Brien K, Steinmetz C, Khoury J. Evaluation of Latex allergy in patients with meningomyelocele. Ann Allergy 69:207, 1992

14. Ylitalo L, Alenius H, Turjanmaa K, Palosuo T, Reunala T. Natural rubber Latex allergy in children: a follow-up study. Clin Exp Allergy 30:1611, 2000

Kaynak Göster