Introduction
This guideline relates to a suspected latex allergy in paediatric patients. With the advent of latex free gloves, this is now increasingly uncommon.
Latex allergies can occur in a number of forms.
Some are IgE mediated while others are due to other immune mechanisms. Risk
factors for latex allergy include:
- Repeated surgical procedures
- Spina bifida
- VP shunt
- Repeated catheterisation
- Repeated latex exposure
Signs and symptoms include:
Mild to moderate local allergic
reaction
- Swelling
of lips, face or eyes
- Hives or welts
- Abdominal pain/ vomiting
Severe systemic allergic reaction
(anaphylaxis)
- Difficulty
breathing
- Swelling of the tongue and/or throat
- Difficulty talking
- Hoarse voice, wheezing or persistent coughing
- Loss of consciousness and/or collapse
- Infants and young children appearing pale and floppy
Severe allergic reaction (anaphylaxis) will typically include
multiple organ systems (i.e. hives and respiratory symptoms), but may also
involve only one system if affecting respiratory or cardio-vascular system.
Latex proteins may also be directly inhaled if they are present in
powder form (eg gloves), causing upper or lower airway symptoms.
Products that may contain latex include:
- Gloves
- Medical equipment, Bandages, Dressing
-
Balloons
- Rubber toys, baby dummies
-
Condoms
Other related issues: Some patients with latex allergy may describe
oropharyngeal itching and swelling when eating certain fruits which are mainly
banana, avocado, or kiwi fruit as there may be cross reacting IgE antibodies
between latex and some other plant allergens. These foods do not need to be avoided,
unless there are symptoms.
When to refer
- All patients with a suspected latex allergy
- If
patient history is suggestive of allergy, even if RAST is negative
- For
further specialised assessment/ testing if diagnosis is not clear (i.e. formal challenge)
Services available
closer to home
Alternative
paediatric allergy services that are able to assess for Latex allergy available
in Victoria include:
- Public paediatric allergy services:
- Consider referral to a private allergist as an
alternative to RCH. Options available on ASCIA website: Locate a
specialist
Referral
criteria/required information
The GP at first consultation is in the best position to get the
most comprehensive information from parents on the details of an allergic
reaction. Please collect and include in your referral as much detail as
possible. Referrals may be rejected if information is insufficient to triage
appropriately
Please include:
- CLEARLY INDICATE if the child has confirmed or
suspected ANAPHYLAXIS. The referral will be triaged as urgent
- Date reaction(s) occurred
- Allergic reaction signs/symptoms (see mild,
moderate and severe symptoms above)
- Potential causes of reaction(s) e.g., form of latex?
- When, where and how did the reaction(s) happen?
- RAST results if these were done
- Treatment given and patient response
- Previous or subsequent exposure to allergen
How to refer
Please complete the above and submit via:
Suggested pre-referral work-up/management
History:
- Type of latex
- Specific details of nature of reaction, previous
or subsequent exposure?
- History of atopy e.g., eczema or asthma
Diagnostics:
- Detection of latex-specific IgE or RAST for Latex if this has been
done
- Interpretation of RAST:
- Test results should be interpreted together
with history
- RAST has limited sensitivity for latex allergy and may be falsely
negative
- Positive latex-specific IgE (RAST) in the presence of a clear history of
allergic reaction confirms clinical allergy
Information for
families
Resources and links
Acknowledgements
The development of this guideline was coordinated
by the Department of Allergy and
Immunology (Dr Jo Smart and Dr Paulina Alhucema). Guideline reviewed in February 2025.