Relation of latex-specific IgE titer and symptoms in patients allergic to latex

BACKGROUND: The relation between latex-specific IgE titer and the type or total number of latex-induced symptoms has not been previously investigated. OBJECTIVE: We sought to determine the association of latex-IgE in vitro assay results with the type, number, or severity of symptoms in patients allergic to latex. METHODS: Ninety-one patients with positive histories and positive skin test responses were identified as having type I allergy. Data was collected for reported symptoms after latex exposure. Symptom severity was quantitated by 2 scores: (1) the total number of symptoms to latex exposure and (2) a symptom severity score (3 = anaphylaxis, 2 = asthma, and 1 = rhinoconjunctivitis, urticaria, or both). All subjects underwent AlaSTAT and CAP tests. RESULTS: AlaSTAT class was associated with total number of symptoms (r = 0.32, P <.001) and severity score (r = 0.33, P <.002). Similarly, CAP class was associated with both number of symptoms (r = 0.32, P <. 0001) and severity score (r = 0.31, P <.001). Among the symptoms reported, asthma had the strongest association with a positive in vitro IgE assay (odds ratio = 6.7 [95% confidence interval = 1.9, 25. 6]), followed by urticaria (odds ratio = 1.9 [95% confidence interval = 0.8, 4.6]). Contact dermatitis had no statistical association with in vitro assays in this study. AlaSTAT and CAP class correlated together significantly (r = 0.58, P <.001). CONCLUSION: Patients allergic to latex with higher AlaSTAT or CAP class were more symptomatic. Increasing class or titer also predicted more severe symptoms. Higher class of either the AlaSTAT or CAP assay to latex was strongly associated with latex-related asthma and urticaria and marginally associated with latex-related rhinoconjunctivitis.