Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942003000400009
Brazilian Journal of Anesthesiology
Scientific Article

Alergia ao látex: diagnóstico acidental após procedimento urológico. Relato de caso

Latex allergy: accidental diagnosis after urological procedure. Case report

Bruno Araújo Verdolin; Walkíria Wingester Villas Boas; Renato Santiago Gomez

http://dx.doi.org/10.1590/S0034-70942003000400009 Braz J Anesthesiol, vol.53, n4, p.496-500, 2003
PDF
Downloads: 0
Views: 710

Resumo

JUSTIFICATIVA E OBJETIVOS: A alergia aos produtos derivados do látex tem-se tornado um problema de grandes proporções, afetando tanto os pacientes como os profissionais da saúde. O objetivo deste relato é descrever o diagnóstico acidental de alergia ao látex após uma cirurgia urológica sob raquianestesia em que o paciente apresentou quadro clínico compatível ao choque anafilático. RELATO DO CASO: Paciente do sexo masculino, 16 anos, portador de lesão de uretra posterior e em uso de sonda vesical por 3 anos, devido a duas cirurgias prévias sem sucesso. Durante o procedimento cirúrgico sob raquianestesia com bupivacaína, o paciente apresentou, logo após a exploração da cavidade abdominal, confusão, dispnéia, prurido e eritema generalizado, broncoespasmo, hipotensão arterial e taquicardia. Houve melhora gradativa das alterações apresentadas com o tratamento instituído. Durante a permanência no hospital, o paciente apresentou, ao soprar um balão de festa, urticária de contato na face e broncoespasmo, que foram prontamente tratados. O teste de punção cutânea e a dosagem de IgE específica para o látex confirmaram a hipótese diagnóstica de alergia ao látex. CONCLUSÕES: A combinação da história clínica do paciente com os dados laboratoriais permitiram a identificação do quadro de alergia ao látex. Esta entidade vem apresentando grande importância recentemente, principalmente naqueles pacientes de risco, como é o do presente caso.

Palavras-chave

ANESTÉSICOS, ANESTÉSICOS, COMPLICAÇÕES, COMPLICAÇÕES, TÉCNICAS ANESTÉSICAS, TÉCNICAS ANESTÉSICAS

Abstract

BACKGROUND AND OBJECTIVES: Allergy to natural rubber latex products has become a major source of concern, affecting both patients and healthcare workers. This report aimed at describing an accidental diagnosis of latex allergy after urological surgery under spinal anesthesia when patient presented clinical manifestations of anaphylactic shock. CASE REPORT: Male patient, 16 years old, with posterior urethra lesion who had been managed for the last 3 years with chronic indwelling latex urethral catheter due to two previous unsuccessful attempts to restore urinary drainage. During surgery under spinal anesthesia, patient presented soon after peritoneal cavity exploration, confusion, dyspnea, generalized pruritus and erythema, bronchospasm, arterial hypotension and tachycardia. Clinical manifestations faded gradually after treatment. During hospital stay and after blowing a toy balloon, patient developed contact hives on the face and bronchospasm, which were promptly treated. Prick and serologic test for latex-specific IgE have confirmed the diagnostic hypothesis of latex allergy. CONCLUSIONS: The combination of patient’s clinical history and lab findings have allowed for the identification of latex allergy. This entity is becoming highly relevant, especially for risk patients, as in this case report.

Keywords

ANESTHETICS, ANESTHETICS, ANESTHETIC TECHNIQUES, ANESTHETIC TECHNIQUES, COMPLICATIONS, COMPLICATIONS

References

Nutter AF. Contact urticaria to rubber. Br J Dermatol. 1979;191:597-598.

Moneret-Vautrin DA, Beaudouin E, Widmer S. Prospective study of risk factors in natural rubber hypersensitivity. J Allergy Clin Immunol. 1993;92:668-677.

Beaudouin E, Prestat F, Schmitt M. High risk of sensitization to latex in children with spina bifida. Eur J Pediatr Surg. 1994;4:90-93.

Niggemann B, Breiteneder H. Latex allergy in children. Int Arch Allergy Immunol. 2000;121:98-107.

Mertes PM, Laxenaire MC. Allergic reactions occurring during anaesthesia. Eur J Anaesth. 2002;19:240-262.

Boxer MB. The dangers of latex allergy. Emerg Med. 1993;25:18-26.

Slater JE. Allergic reactions to natural rubber. Ann Allergy. 1992;68:203-209.

Fisher AA. Allergic contact reactions in health personnel. J Allergy Clin Immunol. 1992;90:729-738.

Sussman G, Tarlo S, Dolovich J. The spectrum of IgE-mediated responses to latex. JAMA. 1991;265:2844-2847.

Kam PCA, Lee MSM, Thompson JF. Latex allergy: an emerging clinical and occupational health problem. Anaesthesia. 1997;52:570-575.

Holzman RS. Latex allergy: an emerging operating room problem. Anesth Analg. 1993;76:635-641.

Steelman VM. Latex allergy precautions: a research based protocol. Nurs Clin North Am. 1995;30:475-493.

Slater JE, Mostello LA, Shauer C. Rubber specific IgE in children with spina bifida. J Urol. 1991;146:578-579.

Gerber AC, Jorg W, Zbinden S. Severe intraoperative anaphylaxis to surgical gloves: latex allergy, an unfamiliar condition. Anesthesiology. 1989;71:800-802.

McKinstry LJ, Fenton WJ, Barrey P. Anaesthesia and the patient with latex allergy. Can J Anaesth. 1992;39:587-589.

Beezhold DH, Beck WC. Surgical gloves powders bind latex antigens. Arch Surg. 1992;127:1354-1357.

Kearns CF, Norris A. Latex allergy and plastic syringes. Anesth Analg. 1996;82:429.

Turjanmaa K, Palosuo T, Alenius H. Latex allergy diagnosis: in vivo and in vitro standardization of a natural rubber latex extract. Allergy. 1992;52:41-50.

5ddd33140e8825037b1da3e9 rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections