Month: January 2017

Allergy to Latex

What is it?

Latex is a milky sap produced by the rubber trees.  It is combined with several chemicals in the manufacturing process to give latex its elastic characteristic.

Where is it found?

Natural rubber latex is used to make many common consumer products including balloons, toys, tires, elastic clothing waistbands, erasers, rubber bands, baby bottles, nipples used on baby bottles, pacifiers, athletic shoes, soles of shoes, condoms, etc.  It is also utilized in the manufacturing of many medical and dental devices such as gloves, dental dams, airway and IV tubing, stethoscopes, and catheters.  Synthetic rubber products (e.g., house paint) are not made with natural latex.

What causes allergies?

The immune system sees the protein in latex as a foreign invader.  To help protect us from foreign aggressors, the immune system mounts a defensive attack against the allergenic proteins found in natural rubber latex by making antibodies (i.e., immunoglobulins) to fight it. When we are exposed to latex products, these antibodies attack the proteins in the latex, releasing chemical mediators into the bloodstream (e.g., histamine, leukotrienes) which are responsible for the symptoms during allergic reactions.

Who is at risk?

  • Health care workers and others who wear latex gloves. Natural rubber proteins can attach to the cornstarch powder used in latex gloves and can become airborne and cause reactions through inhalation.
  • People who have had multiple surgeries, such as children with spinal defects.
  • Rubber industry workers

What are the symptoms?

  • Itching (i.e., pruritus), rash, and/or hives (i.e., urticaria)
  • Nasal congestion, runny nose, and/or itchy nose
  • Wheezing, shortness of breath, chest tightness, and/or coughing
  • Swelling (i.e., angioedema) of parts of the body such as the throat, lips, eyes, and tongue.
  • Nausea and/or dizziness
  • Anaphylaxis, a severe life-threatening reaction manifested by a multiple organ system allergic reaction which may include a drop in blood pressure, breathing difficulty, generalized itching, hives, swelling, and/or abdominal cramping, as well as other symptoms.

The above symptoms usually begin within a few minutes after latex exposure and are categorized as an immediate hypersensitivity reaction.  The reactions usually occur only after a number of exposures, but the severity of reactions can worsen with repeated exposures.

Physical contact with latex can also cause soreness and blistering of the skin which usually begins 2 to 3 days of exposure.  This type of reaction is called allergic contact dermatitis.  It is similar to the reaction that is caused by poison ivy, poison oak, and poison sumac, which is referred to as a delayed-type hypersensitivity reaction.

Are foods a problem?

People who are sensitive to latex can also adversely react to certain fruits and vegetables such as apples, avocados, bananas, chestnuts, carrots, celery, kiwi, melons, papayas, potatoes, and tomatoes due to the sharing of similar proteins (i.e., cross-reactivity).

How is the condition diagnosed?

When the history is suggestive of a latex allergy, a blood test can be done to confirm the diagnosis.  Furthermore, allergy skin testing can also be done in individuals who have a negative blood test but the index of suspicion for a latex allergy is high.

What treatments are available?

As one cannot be desensitized to latex, avoidance of latex exposure (both contact and inhalation) is the only way to protect individuals from untoward reactions.

  • Health care workers should wear synthetic and non-powdered gloves which do not contain natural rubber products.
  • Patients with a history of previous reactions should be exposed only to non-latex medical products and devices and operated upon only in non-latex environments.
  • The latex-allergic individual should wear a medical alert bracelet, so that people are aware of their allergy.
  • The latex-allergic person should always carry an EpiPen, Auvi-Q, and/or Adrenaclick self-injectable device for emergency treatment and know to then go immediately to the closest emergency room.

The board certified allergy specialists at Black & Kletz Allergy have 3 convenient office locations in the Washington, DC, Northern Virginia, and Maryland metropolitan area and are very experienced in the diagnosis and treatment of latex allergies.  Black & Kletz Allergy treat both adults and children and have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  We offer on-site parking at each location and the Washington, DC and McLean, VA offices are Metro accessible. There is a free shuttle that runs between the McLean, VA office and the Spring Hill metro station on the silver line. Please call our office to make an appointment or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day.  Black & Kletz Allergy has been serving the Washington, metropolitan area for more than 50 years and we pride ourselves in providing excellent allergy and asthma care in a professional and pleasant setting.

How the Cold Weather Affects Allergic Individuals and Asthmatics

Now that it is Winter and the temperatures are cold, one may think that they do not have anything to worry about when it comes to allergies and asthma in the Washington, DC metropolitan area like in the cities of McLean, VA (Tysons Corner, VA), and Manassas, VA.  Unfortunately, this is not true, as the cold weather can mimic allergies in many individuals and produce the same symptoms that occur in allergic people.  In addition, during the Winter, there are many allergens that still exist (i.e., dust mites, molds, pet dander and saliva, cockroaches, rodents) which cause allergic and asthmatic symptoms in susceptible individuals.  Furthermore, there are a lot of viruses that are prevalent in the Winter that can also cause symptoms that can be confused with allergies.  These viruses are also responsible for upper respiratory tract infections (URI’s) that are known to exacerbate asthma in many asthmatics.

It is well known that cold air can cause a runny nose and watery eyes.  The runny nose is a result of the vascular constriction caused by the cold air.  Non-allergic individuals that have these symptoms may think they have allergies.  Allergic individuals that have these symptoms may truly be having these symptoms because of the vascular constriction or because they are at increased exposure to allergens found during the Winters such as dust mites, molds, pet dander and saliva, cockroaches, and rodents.  Cold air is also a very well know trigger in many asthmatics and in these patients can cause wheezing, shortness of breath, chest tightness, and/or coughing. Exercising in the cold air is another important trigger for many asthmatics.

During the Winters in the Washington, DC, Northern Virginia, and Maryland metropolitan area, it is common for people to contract a multitude of viruses that cause upper respiratory tract infections.  The most common viruses that are responsible for URI’s include the rhinovirus, influenza virus (i.e., flu), parainfluenza virus, coronavirus, respiratory syncytial virus (i.e., RSV), picornavirus, adenovirus, coxsackievirus, and echovirus.  URI’s cause many symptoms that are the same as allergic rhinitis symptoms such as nasal congestion, runny nose, sneezing, sinus headaches, clogged ears, cough, and fatigue.  In addition, URI’s are known to exacerbate asthma in many asthmatics.

Three other conditions that the cold can cause that can be misconstrued as an allergy include hives (i.e., urticaria)swelling episodes (i.e., angioedema), and generalized itching (i.e., pruritus).  These skin conditions can be caused by exposure to cold air or cold water. There a many factors that can cause hives, swelling episodes, and/or itching; some of which include medication allergies, food allergies, certain infectious diseases, autoimmune disorders, and thyroid abnormalities.  In the Winter in the Washington, DC metro area, one must also think of the cold weather as a cause of these skin conditions.

The board certified allergists at Black & Kletz Allergy have more than 50 years of experience in diagnosing and treating allergies, asthma, hives, swelling episodes, generalized itching, URI’s (including sinus infections and bronchitis) in both adults and children. Whether they are caused by the cold or caused by other factors, Black & Kletz Allergy has the experience and expertise in treating these conditions.  We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA and offer on-site parking at all locations.  The Washington, DC and McLean, VA offices are Metro accessible and we provide a free shuttle that runs between our McLean, VA office and the Spring Hill metro station on the silver line.  To schedule an appointment, please call us or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day.  Black & Kletz Allergy is proud to provide high quality allergy care to the Washington, DC, Northern Virginia, and Maryland metropolitan area residents in a friendly and professional setting.