Ask the Expert

30 year old female wants to know if she is allergic to latex. Relevant history: putting on gloves causes hand swelling and she feels dyspneic. Healthy otherwise, no hx of spinda bifida, no frequent surgeries, no asthma, no allergic rhinitis, no food allergies. No hx of anaphylaxsis. Works in office position as clerk, no hx of working in the medical field or rubber/tire industry. Latex IgE (Quest) 0.31 ClassII. Do I tell her she is allergic?

Thank you for your recent inquiry.

Unfortunately, there is no definitive answer with the information we have. 

So you might consider a latex skin test and challenge. I would consider asking her to bring in the latex gloves that have caused a  reaction (hand swelling and dyspnea) in the past and observe her wearing the gloves. If no reaction occurred it would strongly support a position that she was not allergic to latex. You might also, simultaneously, perform pre- and post- pulmonary function tests as objective confirmation of obstruction if she complained of shortness of breath but did not exhibit and visible cutaneous manifestations. If this type of challenge was negative, what we normally do is prick with the liquid from the soaked latex glove, and then if that is negative, apply a wet glove to the forearm and prick through the glove. A positive test to any one of these challenges would then give you much more confidence in making a diagnosis of latex allergy. if all of the above were negative using the same gloves she has used in the past it would certainly put in question a diagnosis of latex allergy.

If, however, you do not wish to perform such tests, then on the basis only of her in vitro tests, I would think the safest thing to do would be to say she is allergic to latex, but as you know, we would not know this with any certainty. 

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.