Kim KT. Safadi GS. Sheikh KM., Diagnostic evaluation of type I latex allergy. Annals of Allergy, Asthma, & Immunology. 80(1):66-70, 1998.
Because there is no universally accepted method for the diagnosis of latex allergy is currently available in the United States, the authors determined the accuracy of clinical assessment in predicting type I latex allergy, and compare the ability of various latex skin test preparations and in vitro assays in confirming the diagnosis of latex allergy. Subjects were classified into "history positive," "history ambiguous," or "history negative" based on reports of clinical symptoms. Skin prick tests were performed with ammoniated latex and glove extracts. Sera were analyzed for latex-specific IgE using the Pharmacia CAP and DPC AlaSTAT assays. In the study, a total of 207 subjects had histories taken, skin testing, and blood drawn. Out of 49 type I latex-allergy "history positive," 42 (86%) were skin test positive, and 24 (49%) were serum positive. Fifty-nine subjects were latex allergy "history ambiguous." In this group, skin testing showed 19 (32%) positives, and latex-specific IgE were detected in 10 (17%). Out of 99 latex "history negative," 9 (9%) were skin test positive, and 11 (11%) were positive for latex-specific IgE. Out of the 61 subjects with IgE symptoms following latex exposure who were skin test positive, a positive in vitro assay was found in 32 (52%). The authors conclude that skin testing is more likely to confirm a positive latex allergy history. Use of raw ammoniated and glove skin testing preparation sources combined added to the diagnostic sensitivity. AlaSTAT and CAP correlated well with each other and had good negative predictive value, but lack the sensitivity of skin testing. AlaSTAT and CAP assays combined increased the diagnostic sensitivity as compared to using one in vitro test alone.