Latex allergies affects many workers(especially health workers), and has a significant impact on productivity and loss of work. There is no commercially available diagnostic method to confirm IgE-mediated latex hypersensitivity. Allergy specialist in the community have tried the latex glove test but has poor validity, and serum IgE titers to latex can be ordered but has poor sensitivity. A latex allergen skin prick test has been used for investigational purposes but is not commercially available. The nasal provocation test is interesting but requires further studies.
From Reuters Health Information
NEW YORK (Reuters Health) Jul 21 - The nasal provocation test is more sensitive than the glove test for diagnosing natural rubber latex allergy, according to a report in the June issue of Allergy.
However, a standard nasal provocation method has yet to be established, according to Dr. Mehmet Unsel and researchers from Ege University Medical Faculty, Izmir, Turkey.
The nasal provocation test was positive in 84.6% and negative in 15.4% of patients with positive skin prick test to natural rubber latex, the authors report, compared with 50% positive and 50% negative glove responses.
Nasal provocation test results were negative in patients with positive skin prick tests to other inhaler allergens and in a control group with no allergic diseases.
Using skin prick test positivity to natural rubber latex and a history of natural rubber latex-associated rhinitis as the gold standard for diagnosing natural rubber latex allergy, nasal provocation test had a sensitivity of 96%, specificity of 100%, negative predictive value of 98%, and positive predicative value of 100%, the investigators note.
In comparison, the glove use test had a sensitivity of 81%, specificity of 90%, negative predictive value of 75%, and positive predictive value of 93%.
"Nasal provocation test was successfully used for the first time in the diagnosis of natural rubber latex allergy," the authors conclude.
Allergy 2009;64:862-867.
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