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Vol. 12. Issue 1.
Pages 36-42 (January 2001)
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Vol. 12. Issue 1.
Pages 36-42 (January 2001)
Alergia al látex en pacientes con espina bífida: Prevención y tratamiento
Latex allergy in spina bifida patients: prevention and treatment
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J.F. Martínez-Lage, M.A. Moltó
Unidad de Neurocirugía Pediátrica. Hospital Universitario “Virgen de la Arrixaca”. Murcia
J.A. Pagan*
* Unidad de Neurocirugía. Sección de Alergia. Hospital Universitario “Virgen de la Arrixaca”. Murcia
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Resumen

La alergia al látex constituye un problema sanitario de interés creciente por la posibilidad de manifestaciones clínicas graves que puede acarrear. Diversos estudios señalan una incidencia de alergia al látex en pacientes con espina bífida (EB) que oscila entre el 10% y 73%. Desde el cierre quirúrgico inicial del mielomeningocele, los niños con EB se ven sometidos a multitud de operaciones por los problemas ortopédicos, urológicos y neurológicos qué presentan. En consecuencia, están expuestos a diversos productos que contienen látex durante un gran número de intervenciones. Varios estudios indican que la sensibilización y la alergia al látex en niños con EB está en relación con la edad y sobre todo con el número de operaciones a que son sometidos, sin que se puedan descartar factores genéticos predisponentes. El desarrollo de esta alergia, y de sus manifestaciones, en individuos con EB constituye, por tanto, una complicación susceptible de prevención. Con este fin, hemos elaborado en nuestro hospital unos protocolos de manejo para tres tipos de situaciones que se pueden presentar en estos pacientes. Estas medidas consisten en: (1) Evitar el uso de productos fabricados con látex desde el nacimiento de los niños con EB. (2) En niños operados de mielomeningocele y que aún no han desarrollado manifestaciones clínicas de alergia al látex, evitar la ulterior exposición a esta sustancia durante los sucesivos ingresos e intervenciones. (3) En niños con alergia conocida al látex, disponer de cuidados de enfermería y de un “quirófano sin látex”. Las medidas que se han puesto en práctica son fáciles de introducir, no suponen un gran coste económico, ni una mayor incomodidad para el personal del hospital.

Palabras clave:
Alergia al látex
Espina bífida
Mielomeningocele
Hidrocefalia
Anclaje medular
Neurocirugía pediátrica
Summary

Latex allergy has become a health problem of growing interest due to the severe clinical manifestations it may produce. Previous reports indtcate a prevalence of latex allergy in patients with spina bifida (SB) ranging between 10% and 73%. From the initial surgical repair of the myelomeningocele, children with SB are submitted to múltiple surgeries due to the neurologic, orthopedic and urologic problems they may present. Consequently, these children are exposed to several latex-containing products during their multiple interventions. Several reports indtcate that latex allergy in SB children is related to age, and especially to the number of operations that they are given, and perhaps to an unknown genetic predisposition. Accordingly, Iatex allergy manifestations can be prevented. In this connection, we have elaborated ai our hospital protocols for the management of the three clinical situations in which these patients can present. These measures include: (1) To avoid using latex-containing products since the birth of children with SB. (2) In children already operated of myelomeningocele but without evidence of latex allergy, to prevent the use of Iatex materials during their successive admissions to hospital and during further surgeries. And (3) In children known to have developed Iatex allergy, to dispose of especial nursing measures and of a latex-free operating room. The preventive measures that have been started at our Hospital are easy to carry out, do not suppose a high economic cost, and are not uncomfortable for the hospital's staff.

Key words:
Latex allergy
Spina bifida
Tethered cord
Pediatric neurosurgery
Meningomyelocele
Hydrocephalus

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