Document Detail


A longitudinal study of resolution of allergy to well-cooked and uncooked egg.
MedLine Citation:
PMID:  21488997     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background Egg allergy is common and although resolution to uncooked egg has been demonstrated, there is lack of evidence to guide reintroduction of well-cooked egg. Objectives To examine the rate of resolution to well-cooked, compared with uncooked egg in children, and safety of egg challenges. Method A longitudinal study of egg-allergic children from 2004 to 2010, who underwent challenge with well-cooked and if negative, uncooked egg. Participants underwent repeat annual challenges and egg-specific IgE measurement. Results One hundred and eighty-one open egg challenges were performed in 95 children whose median age of allergy onset was 12 months. Fifty-three of 95 (56%) had at least one annual repeat challenge. Pre-study historical reactions occurred to baked egg in five (5%), lightly cooked in 58 (61%) and uncooked in nine (9%); respiratory reactions occurred in 11 (12%) and seven (7%) had anaphylaxis; adrenaline was used during five reactions. There were 77 well-cooked and 104 uncooked egg challenges. Tolerance was gained twice as rapidly to well-cooked than uncooked egg (median 5.6 vs. 10.3 years; P<0.0001) and continued to 13 years; hazard ratio 2.23 (95% confidence interval 1.6-3.9). Nearly 1/3 had resolved allergy to well-cooked egg at 3 years and 2/3 at 6 years. Of 28/77 (37%) positive well-cooked egg challenges, 65% had cutaneous symptoms, 68% gastrointestinal and 39% rhinitis, with no other respiratory reactions. Adrenaline was not required. Conclusions and Clinical Relevance Resolution of egg allergy takes place over many years, with children outgrowing allergy to well-cooked egg approximately twice as quickly as they outgrow allergy to uncooked egg. There were no severe reactions to well-cooked egg challenge, and adrenaline was not required. Our data support initiation of home reintroduction of well-cooked egg from 2 to 3 years of age in children with previous mild reactions and no asthma. Resolution continues to occur in older children, so that despite an earlier positive challenge, attempts at reintroduction should be continued. Cite this as: A. Clark, S. Islam, Y. King, J. Deighton, S. Szun, K. Anagnostou and P. Ewan, Clinical & Experimental Allergy, 2011 (41) 706-712.
Authors:
A Clark; S Islam; Y King; J Deighton; S Szun; K Anagnostou; P Ewan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology     Volume:  41     ISSN:  1365-2222     ISO Abbreviation:  Clin. Exp. Allergy     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8906443     Medline TA:  Clin Exp Allergy     Country:  England    
Other Details:
Languages:  eng     Pagination:  706-12     Citation Subset:  IM    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Department of Allergy, Box 40, Cambridge University Hospitals, NHS trust, Addenbrooke's Hospital, Cambridge, UK Department of Medicine, Box 157, Cambridge University Hospitals, NHS trust, Addenbrooke's Hospital, Cambridge, UK Department of Paediatrics, Box 181, Cambridge University Hospitals, NHS trust, Addenbrooke's Hospital, Cambridge, UK.
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