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Latex allergy (Investigations (Tryptase (Timing (1 hour, 4 hours, 24 hours…
Latex allergy
Investigations
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Tryptase
Raised tryptase is a good marker of anaphylactic / toid reactions (helps distinguish mast cell dependent reactions from other systemic disturbances such as cardiogenic shock)
A negative level does not exclude it - may have anaphylactic reaction involving Basophils (do not contain Tryptase). Referral for skin testing is still indicated
Timing
1 hour, 4 hours, 24 hours after the onset of the reaction
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RAST tests
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Can be performed while the patient has extensive skin lesions, is on antihistamines, or has presented with recent episode of anaphylaxis
High specificity but low sensitivity, therefore risk of false negatives
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History
Risk Factors:
Occupational exposure e.g. health care workers, hairdressers, food service workers, police officers
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Allergy to fruits (=latex-fruit syndrome: bananas, avocados, strawberries, mangoes, kiwi, chestnuts, balloons)
Exposure to latex e.g. gloves, IDC
Temporal association
If exposure is airborne, symptoms develop ~ 30mins after exposure
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Examination
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Differential diagnosis
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Anaphylaxis to something other than latex e.g. Abx, Muscle Relaxant
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