Acute allergic reactions to latex are managed in the same manner
as other IgE-mediated reactions based on specific symptoms. The
patient should be removed from the source of the latex exposure
to prevent further exacerbations of the allergic reaction. Urticaria
or angioedema should be treated with oral antihistamines, and rhinitis
and conjunctivitis may be treated symptomatically with oral antihistamines
or topically with ocular and nasal antihistamines. Inhaled bronchodilators
are indicated for bronchospasm. Anaphylaxis is treated primarily
with epinephrine, though corticosteroids, IV fluids, and other supportive
care may be required. Once a diagnosis of latex allergy has been
established and documented, the long-term management of such patients
requires latex avoidance and education of the patient. Minimization
of exposure to dipped rubber products such as gloves, balloons,
and condoms is of primary importance. Patients should inform all health
care providers of the latex allergy and consider medical alert identification
indicating the allergy. Even though the health care system is often
equipped with appropriate alternative rubber-free products, it is
advisable for patients to have a personal supply of nonlatex gloves
for use when they require medical or dental care and to carry self-injectable
epinephrine. Medical procedures on latex allergic patients should be
conducted in a latex-free environment where nonlatex gloves are
worn by medical providers and no latex accessories come in direct
contact with the patient.5,6 Anecdotal reports
have described latex allergic patients developing reactions from
the injection of medications through latex ports in IV tubing. However,
the dry rubber products used in such closures generally have low
levels of extractable protein compared to dipped products (gloves)
made from liquid latex. Thus, the need to eliminate latex in IV
tubing and medication vial closures is controversial. An updated
list of non-latex alternative medical supplies available in the
United States is provided by the American Latex Allergy Association.7 Patients
diagnosed with latex allergy should also be asked about allergic signs
or symptoms when they eat the foods included in the “latex-fruit” syndrome
as listed above. If patients tolerate these foods without symptoms,
there is no compelling reason to avoid them; however, latex-allergic
individuals should be cautious when eating these foods for the first
time. A variety of latex immunotherapies are under investigation
but none are yet adequate for routine use.8