No Poinsettia this Christmas

Tripura Mantha Bala, MD; Mukta Panda, MD

Disclosures

South Med J. 2006;99(7):772-773. 

In This Article

Discussion

Latex allergy, first recognized in the 1970s, has been a major health concern, especially in the work place. An increase in the incidence of latex protein allergy occurred in the late 1980s due to the implementation of universal precautions, which caused a dramatic rise in the manufacture of latex gloves.[2] The number of individuals with latex allergy has decreased since the mid-1990s due to the availability of nonlatex gloves or powder-free gloves.[4]

Eight percent of healthcare workers have latex allergy. There were more than 1,000 reports of latex allergy, including 15 deaths, during the time period between 1988 to 1992.[2,5] Increased incidence of latex allergy is seen in children with spina bifida and other neural tube defects and in those with urogenital abnormalities.[2]

Several vegetables, such as potatoes, avocados, celery and tomatoes, share cross-reactivity with latex. Fruits like bananas, apples, melons, figs, kiwi and papayas are also known to be associated with latex cross-reactivity.[6,7]

Researchers at the Medical College of Georgia demonstrated in their studies that 40% of individuals with latex allergy are allergic to poinsettia. This is because latex and poinsettia share several proteins. They found IgE antibodies to poinsettia in the blood samples of people with latex allergy. By means of special tests like gel electrophoresis, immunoblot and immunoblot inhibition, two proteins called cross- reactive allergens were identified. These are major and minor latex allergen proteins, Hev b 6.01 and Hev b10, respectively.[3]

Limited published case reports are available on latex allergy and cross-reactivity with poinsettia. This may be due to the fact that with improved technology of manufacturing of latex gloves, latex allergy has been markedly reduced, thus making cross-reactivity to poinsettia minimal. One documented case discusses bronchial asthma induced by exposure to the poinsettia plant in a 6-year-old child. He had a 20% decrease in Forced Expiratory Volume 1 with bronchial challenge to the poinsettia extract.[8]

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