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AND THE ANSWERS ARE . . .

  1. The sensitivity of in vitro tests for IgE anti-latex antibodies is greater than that of NRL skin testing.
    False
  2. There is a sizable cross-reactivity between sensitivity to NRL and to kiwi.
    True
  3. Individuals allergic to NRL are at increased risk for allergic reactions if they inhale the fumes of latex paints.
    False
  4. Individuals allergic to NRL are at increased risk for reacting to fluids in contact with hard rubber stoppers.
    False
  5. Low protein, non-powdered latex gloves are much less likely to induce NRL allergy than are the traditional latex gloves.
    True

Discussion
Allergic reactions to NRL are induced by contact with or inhalation of one or more allergens which elute from soft NRL products, particularly latex gloves. Such allergens do not elate from hard rubber items such as stoppers. Possible NRL sensitivity is initially evaluated by an in vitro test for IgE antibodies. This test is positive in about 80% of those shown to be NRL allergic by challenge tests. Some NRL allergic individuals with negative in vitro tests will exhibit positive latex allergen skin tests. Thus NRL skin tests appear to be more sensitive than the in vitro tests. However, most investigators recommend doing such skin tests only in those with suggestive histories and negative in vitro tests to avoid a possible systemic reaction to skin testing in individuals very allergic to NRL.

A sizable percentage of NRL allergic individuals will exhibit allergic reactions to certain foods (banana, kiwi, avocado, chestnut). However, they do not react to latex paints which do not contain cross-reacting allergens. The term "latex paint" describes the consistency of the paint, not to any NRL allergens present.

As noted above, NRL sensitivity is most commonly induced by allergens eluting from latex gloves. The lubricating powder customarily placed in such gloves aids in dissemination of such allergens. It has been shown that use of non-powdered latex gloves constructed to contain low levels of the sensitizing proteins are much less likely to induce NRL sensitivity.

References
1) Immunol Allergy Clin North Am. 2005 ;25:389-405
2) Int Arch Allergy Immunol 2000;121:292-9
3) Toxicol Rev. 2004;23:123-34




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