D2.402 - Latex Sensitization as a Risk Factor for Perioperative Hypersensitivity Reactions in Asthmatic Children

Latex remains one of the most common causes of perioperative hypersensitivity reactions (PHR), particularly in pediatric patients with allergic diseases. Children with allergic asthma (AA) are considered a high-risk group due to underlying IgE-mediated sensitization and chronic airway inflammation. However, the contribution of latex sensitization to the development of PHR in asthmatic children has not been sufficiently evaluated.

A retrospective analysis was performed on medical records of 135 children aged 6–12 years with AA who underwent elective surgical procedures between 2018 and 2024. Clinical manifestations of perioperative hypersensitivity reactions were evaluated. Latex sensitization was assessed using skin prick testing (SPT) and measurement of specific IgE antibodies to natural rubber latex. Statistical analysis included Fisher’s exact test, with odds ratios (OR) and 95% confidence intervals (CI) calculated to assess the association between latex sensitization and perioperative reactions.

Clinically significant PHR developed predominantly during the induction phase of anesthesia, occurring in 22 of 30 cases (73.3%), and were characterized by cutaneous manifestations in 20 children (66.6%), intraoperative bronchospasm in 8 children (26.7%), and anaphylaxis in 2 children (6.7%). Latex sensitization, confirmed by positive skin prick testing, was identified in 13 children (9.6% of the total cohort). PHR occurred in 6 of these patients, accounting for 20.0% of all children with perioperative reactions, whereas latex sensitization without clinically significant perioperative events was observed in 7 children (6.7% of patients without perioperative hypersensitivity reactions). Children with allergic asthma and latex sensitization had a significantly increased likelihood of perioperative hypersensitivity reactions (OR 3.50, 95% CI 1.13–10.85; Fisher’s exact test, p = 0.038).

Latex sensitization is a clinically relevant risk factor for PHR in children with AA. The combination of latex sensitization and underlying allergic inflammation significantly increases the likelihood of adverse perioperative events, particularly during anesthesia induction. Targeted preoperative assessment, including latex allergy testing and evaluation of immunological markers, may enhance perioperative safety and reduce the risk of severe hypersensitivity reactions in asthmatic children.