Q:

2/5/2013
For patients undergoing surgery with a history of food allergies, such as kiwi or other food known to have cross reactivity to latex, should we use latex precautions for these patients and assume they may be allergic to latex? What is the clinical evidence that patients with food allergies with cross reactivity to latex may also have allergies to latex? Thank you.

A:

Thank you for your inquiry.

I am going to refer your question to Dr. Kevin Kelly who is a nationally known expert in latex allergy. As soon as we hear from Dr. Kelly, we will forward his response to you.

Sincerely,
Phil Lieberman, M.D.

We received a response from Dr. Kevin Kelly regarding your Ask the Expert inquiry. Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

Response from Dr. Kevn Kelly:
Older studies from Europe from excellent investigators suggested the following:
 
1. People with known latex allergy may have clinical adverse reactions to foods in up to 50% of the population.

2. For those who have proven IgE mediated clinical reactivity to highly cross reactive foods (kiwi, banana, and avocado) up to 10% of those patients may clinically react to latex.
 
Given the relative ease of implementing latex precautions, many of these patients can easily be cared for in a latex safe environment until diagnostic testing can be performed. The false negative rate on serologic assays is very high so some would use latex precautions regardless of the test result.

From a “prudent point of view”, I personally would recommend latex safe surgeries and precautions in with those three fruit allergies. I may be wrong but I am harming no one by this approach to my knowledge.

Thanks.
Kevin J. Kelly, M.D.
Professor of Pediatrics (Allergy/Immunology) & Medicine Medical College of Wisconsin

AAAAI - American Academy of Allergy Asthma & Immunology