Abstract
Purpose
To report intraoperative latex anaphylaxis that occurred in an otherwise healthy child. Although latex anaphylaxis is seen in patients with myelodysplasia, genitourinary anomalies, sensitised healthcare workers, and patients with frequent exposure to latex, it has not been described in otherwise healthy children.
Clinical features
A nine-year-old girl developed intraoperative latex anaphylaxis manifested by increased airway pressure, expiratory wheezing, a decrease in oxygen saturation, severe hypotension and urticaria. The patient was treated with 5 μg·kg−1 epinephrine iv and 5 mg·kg−1 hydrocortisone iv. She required an epinephrine infusion of 0.4 μg·kg−1 ·min−1 and prolonged ICU admission. Her only previous latex exposure was during plastic surgical procedures. Latex allergy was confirmed weeks later using the prick method allergy testing.
Conclusion
Latex anaphylaxis can occur in otherwise healthy children whose only latex exposure occurred during a previous operation, including plastic surgery.
Résumé
Objectif
Rapporter un cas d’anaphylaxie peropératoire au latex chez un enfant par ailleurs bien portant. Bien que l’anaphylaxie au latex se rencontre ordinairement chez les myélodysplasiques, les porteurs d’anomalies urinaires, les travailleurs de la santé sensibilisés et les patients fréquemment exposés au latex, elle n’a pas été décrite chez des enfants en bonne santé.
Éléments cliniques
Une fillette de neuf ans a présenté une anaphylaxie peropératoire au latex qui s’est manifestée par une augmentation de la pression des voies aériennes, du wheezing expiratoire, une baisse de la saturation en oxygène, de l’hypotension profonde et de l’urticaire. Un traitement à l’éphédrine 5 μg·kg−1 iv et à l’hydrocortisone 5 mg·kg−1 iv a été administré. La gravité de son état a nécessité une perfusion d’épinéphrine de 4 μg·kg−1 ·min−1 et un séjour prolongé à l’USI. Sa seule exposition antérieure au latex avait été pendant une chirurgie plastique. L’allergie au latex a été confirmée quelques semaines plus tard par intradermoréaction.
Conclusion
L’anaphylaxie au latex peut survenir chez des enfants bien portants chez qui la seule exposition au latex est survenue au cours d’une intervention antérieure, incluant la chirurgie plastique.
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Zestos, M.M., Creighton, R. Latex anaphylaxis during tissue expander insertion in a healthy child. Can J Anaesth 44, 1275–1277 (1997). https://doi.org/10.1007/BF03012775
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DOI: https://doi.org/10.1007/BF03012775