Background: IgE-mediated hypersensitivity to latex has been recognized as an increasing health problem with far-reaching consequences for patients, regarding both their occupational situation and safety in medical care. Therefore, a correct diagnosis of natural rubber latex (NRL) allergy is essential. The purpose of the study was to evaluate sensitivity and specificity of several established diagnostic methods for NRL allergy (in vitro assays and skin prick test) in relation to a new semiquantitative dipstick test (Allergodip®-Latex, Allergopharma) as a screening test for NRL allergy. Methods: Data obtained with quantitative assays including Pharmacia CAP System® (FEIA), DPC-AlaSTAT® and Magic Lite® were compared with the dipstick test results in latex-sensitized (n = 151) and nonsensitized persons (n = 232). In addition these in vitro findings were related to clinical symptoms after exposure to latex and skin prick test results with a panel of different latex allergen extracts. Results: When comparing sensitivity and specificity of all in vitro assays relative to skin prick test results the Pharmacia CAP System® (FEIA) had the highest sensitivity in the range of 90%. Sensitivity of the other in vitro assays was in the range of 73.7–74.9%, specificity varied from 85.3 to 89.8%. A diagnostic standard was defined in terms of at least three corresponding test results out of all diagnostic methods (in vitro assays and skin prick test). The sensitivity and specificity of each diagnostic test were determined relative to this diagnostic standard. Hereby the Allergodip test results showed a sensitivity of 91% and a specificity of 93%. Conclusion: The dipstick test results are in line with the data of the other in vitro assays. In contrast to other in vitro assays the dipstick test requires no further laboratory equipment and is easy to perform.

Keywords:
Allergy, natural rubber latex, Skin prick test, IgE, specific, Dipstick test
1.
Frankland AW: Latex allergy. Clin Exp Allergy 1995;25:199–201.
2.
Wakelin SH, White IR: Natural rubber latex allergy. Clin Exp Dermatol 1999;24:245–248.
3.
Warshaw EM: Latex allergy. J Am Acad Dermatol 1998;39/1:1–24.
4.
Slater JE: Latex allergy. J Allergy Clin Immunol 1994;94:139–149.
5.
Niggemann B, Wahn U: A new dipstick test (Allergodip®) for in vitro diagnosis of latex allergy – Validation in patients with spina bifida. Pediatr Allergy Immunol 2000;11:56–59.
6.
Brehler R, Theissen U, Mohr C, Luger T: ‘Latex-fruit syndrome’: Frequency of cross-reacting IgE antibodies. Allergy 1997;52:404–410.
7.
Moir GFJ: Ultracentrifugation and staining of hevea latex. Nature 1959;184:1926–1928.
8.
Chen Z, Van Kampen V, Raulf-Heimsoth M, Baur X: Allergenic and antigenic mapping of epitopes recognized by human, murine and rabbit antibodies. Clin Exp Immunol 1996;26:406–415.
9.
Yeang HY, Cheong KF, Sunderasan E, Hamzah S, Chew NP, Hamid S, Hamilton RG, Cardosa MJ: The 14.6 kd rubber elongation factor (Hev b 1) and the 24 kd (Hev b 3) rubber particle proteins are recognized by IgE from patients with spina bifida and latex allergy. J Allergy Clin Immunol 1996;98:628–639.
10.
Hamilton RG, Adikinson NF Jr: Natural rubber latex skin testing reagents: Safety and diagnostic accuracy of nonammoniated latex, ammoniated latex, and latex rubber glove extracts. J Allergy Clin Immunol 1996;98:872–883.
11.
Kim KT, Safadi GS, Sheikh K: Diagnostic evaluation of type I latex allergy. Ann Allergy Asthma Immunol 1998;80:66–70.
12.
Moneret-Vautrin DA, Laxenaire MC: Routine testing for latex allergy in patients with spina bifida is not recommended (reply). Anesthesiology 1991;74:391–392.
13.
Blanco C, Carillo T, Ortega N, Alvarez M, Dominguez C, Castillo R: Comparison of skin prick test and specific IgE determination for diagnosis of latex allergy. Clin Exp Allergy 1998;28:971–976.
14.
Hadjiliadis D, Banks DE, Tarlo SM: The relationship between latex skin prick test responses and clinical allergic responses. J Allergy Clin Immunol 1996;97/6:1202–1206.
15.
Kim KT, Safadi GS: Relation of latex-specific IgE titer and symptoms in patients allergic to latex. J Allergy Clin Immunol 1999;103:671–677.
16.
Ebo DG, Stevens WJ, Bridts CH, De Clerck LS: Latex-specific IgE, skin testing, and lymphocyte transformation to latex in latex allergy. J Allergy Clin Immunol 1997;100:618–623.
© 2001 S. Karger AG, Basel
2001
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.