Abstract
Resolution of egg allergy occurs in the majority of egg allergic children. Positive specific IgE antibodies to ovomucoid (OVM) have been suggested to be of greater predictive value for persistent egg allergy than specific IgE to egg white. The performance of OVM-specific IgE antibody levels in a cohort of children referred for a routine egg challenge was compared with egg white specific IgE levels in predicting a positive egg challenge. 24/47 subjects had persistent egg allergy. Receiver operating characteristic analysis showed that OVM-specific IgE testing was the most useful test for the diagnosis of persistent egg allergy. The optimal decision points for the prediction of persistent egg allergy were >0.35 kUA/L for specific IgE levels to both EW and OVM, and ≥3 mm for SPT. Children with specific IgE levels suggestive of persistent egg allergy need not be subject to an egg provocation challenge, reducing both costs and risks to the child.
Highlights
Egg allergy is common in early childhood, affecting 12% of all preschool children and may be associated with severe symptoms, including anaphylaxis [1,2,3]
This study showed a SPT wheal diameter ≥3 mm to egg white to be very highly predictive of persistent egg allergy, it could not be used to distinguish children who could tolerate extensively heated eggs from those who could not
In a group of children from a tertiary allergic clinic, measurement of specific IgE antibodies for ovomucoid was the best test for the prediction of persistent egg allergy
Summary
Egg allergy is common in early childhood, affecting 12% of all preschool children and may be associated with severe symptoms, including anaphylaxis [1,2,3]. Remission of type 1 hypersensitivity to hen egg occurs in the majority of cases, hypersensitivity may persist through adolescence into adulthood, in which 12% of food allergies are attributed to egg [4,5,6,7,8,9]. The ubiquitous inclusion of egg in prepared foods as a result of its useful functional properties—including binding and emulsifying— renders complete egg avoidance difficult. The sooner tolerance to egg is ascertained, the sooner a child can enjoy a normal, unrestricted diet. This alleviates the social and emotional burden associated with having a food allergy and is important for normal growth and development [13]
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