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Anaphylaxis associated with latex allergy during barium enema examinations.

Abstract
During the interval from January 1989 to March 1990, signs and symptoms of anaphylaxis developed in six patients during barium enema examinations in our institution. In all six cases the symptoms of anaphylaxis began during the procedure, usually within 10 min of starting the examination. The principal manifestation of anaphylaxis was severe hypotension, usually accompanied by edema and urticaria. The symptoms were considered potentially life threatening in all patients, and one patient died despite prompt recognition of the anaphylactic nature of the reaction and resuscitative efforts. Serum samples were obtained within a few hours of the reaction in two patients and at autopsy in the fatal case: all three samples showed elevated concentrations of mast cell tryptase, demonstrating the systemic release of anaphylactic mediators. In vitro tests demonstrated the presence of immunoglobulin E antibodies specific for latex allergens in five of the six cases. Further in vitro inhibition tests confirmed the specificity of the antibodies for latex allergens and demonstrated that similar allergens were found in both raw latex, latex gloves, and catheter balloons. Only one patient was willing to undergo a skin test, and her skin test was positive for extracts of latex products. After considering multiple possibilities, we conclude that the reactions associated with barium enemas observed in these six patients are most probably the result of latex allergy.
AuthorsD R Ownby, M Tomlanovich, N Sammons, J McCullough
JournalAJR. American journal of roentgenology (AJR Am J Roentgenol) Vol. 156 Issue 5 Pg. 903-8 (May 1991) ISSN: 0361-803X [Print] United States
PMID2017949 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Latex
  • Barium Sulfate
Topics
  • Adult
  • Aged
  • Anaphylaxis (etiology)
  • Barium Sulfate
  • Enema (adverse effects)
  • Female
  • Humans
  • Hypersensitivity (etiology)
  • Latex (adverse effects)
  • Middle Aged

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