Latex Allergy Workup
- Author: Amy J Behrman, MD; Chief Editor: Erik D Schraga, MD more...
ED diagnosis and management depends on the history and the physical examination. Results of laboratory tests sent from the ED are not generally available in a useful time frame. Several types of diagnostic studies are useful in nonemergent evaluations.
Total serum IgE may be elevated in patients with type I allergy, but it is neither sensitive nor specific.
Radioimmunoassay test (RAST) results for latex-specific IgE range from 50-100% sensitive and 63-100% specific. Predictive value depends on the exact test used, the patient population, and the source of allergen. RAST can be a useful and safe confirmatory test in patients with suggestive clinical histories. The sensitivity and specificity are improving with newer-generation testing methods.
Enzyme-linked assays of latex-specific IgE (ELISA) may serve the same purpose.
Genomic profiling may become a useful tool for predicting risk, guiding therapy, and understanding pathophysiology in latex allergy.
See the list below:
Skin patch testing is useful in identifying specific allergens in patients with type IV hypersensitivity to latex products. 
Skin prick testing with latex extracts is sensitive, specific, and rapid; however, it carries the risk of anaphylaxis.  Significant variability in the allergen content of extracts continues to limit the reliability and reproducibility of skin prick testing.
Testing with glove fingertips applied to the patient's skin is useful when the history is consistent with latex allergy but the blood tests are negative. It carries the risk of anaphylaxis in type I-sensitized patients.
If type I latex allergy is suspected, all procedures should be performed with latex-free instruments, devices, and protective clothing.
Preprocedure screening by history should include risk factors such as occupational and nonoccupational risk groups, tropical fruit allergy, and atopy as well as documented latex allergy.
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