Corridor Consult

Michael S Kaplan, MD

Summer 2007 - Volume 11 Number 3

Report of a Case

A nurse, age 32 years, with a history of hives, angioedema of the lips and eyelids, and stridor after eating an avocado, eats a plum and within minutes experiences similar symptoms. Her condition partially responds to initial treatment with a fast-acting antihistamine and an injection of epinephrine, yet she experiences a second wave of symptoms as well as hypotension while being transported to the Emergency Department by paramedics.

This nurse has latex sensitivity that developed after several years of repeated exposure to latex gloves. She had subsequently developed a cross-sensitivity to foods associated with latex allergy, namely avocados and stone fruits (pitted) such as plums. Her anaphylaxis was compounded by the use of latex gloves and equipment during the paramedic transport. (Note: Currently the chances of this happening are low because the use of natural-rubber latex has been significantly reduced in the medical environment. However, previously sensitized health care workers need to be cautious.)

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