Latex allergy in non-spina bifida patients: Unfamiliar intra-operative anaphylaxis

Background: The medical literature has described the prevalence of latex allergy in the spina bifida population and its implications for surgical intervention. We report three cases of severe and unexpected intra-operative anaphylaxis secondary to latex exposure in non-spina bifida patients. Methods: A retrospective review of case notes identified three non-spina bifida patients who suffered intra-operative anaphylaxis due to latex allergy. Personal and telephone interview and patient chart review was performed to detail a past history of multiple latex exposure, atopy, the anaphylaxis event and the postoperative outcome. Results: Three non-spina bifida patients are described. One suffered a cardiopulmonary arrest, the remaining two patients had severe vascular hypotension and airway resistance that was only relieved after administration of vasoconstrictors and bronchodilators. Post-operatively, all three tested strongly positive to latex allergen testing. Each patient had a history of multiple surgical latex exposure and specific allergies or allergic- type symptoms pre-operatively. Conclusion: We believe that the predictors of a severe allergic reaction to latex with surgical exposure in non-spina bifida patients may be similar to those predictors known in the spina bifida population. Identification of such at-risk patients will reduce the risk of significant intra-operative morbidity and possible mortality by the introduction of a latex-free operating environment.