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Safety and feasibility of heated egg yolk challenge for children with egg allergies
Author(s) -
Yanagida Noriyuki,
Sato Sakura,
Asaumi Tomoyuki,
Ogura Kiyotake,
Borres Magnus P.,
Ebisawa Motohiro
Publication year - 2017
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12705
Subject(s) - yolk , egg allergy , egg white , medicine , food allergy , allergy , anaphylaxis , oral food challenge , immunoglobulin e , food science , immunology , biology , antibody
Background Hen's egg allergy is a frequent cause of childhood food allergy. Egg yolk is used in various commonly consumed foods; if children with allergy to hen's egg could eat heated egg yolk, their quality of life ( QOL ) would improve. No reports exist regarding oral food challenges ( OFC s) for heated egg yolk. We aimed to clarify whether pediatric patients allergic to hen's egg could consume heated egg yolk. Methods Data from pediatric patients who had undergone OFC s for heated egg yolk were evaluated retrospectively. Results Among 919 patients, positive OFC results were obtained in 17.0% of patients; seven presented with severe symptoms. Older age, high specific IgE value for ovomucoid, low total IgE levels, and history of anaphylaxis related to food other than hen's egg were risk factors for positive OFC results. Specific IgE values for egg white, ovomucoid, and egg yolk, indicative of a negative predictive value >95%, were 0.71, 0.41, and 0.17 kU A /l, respectively. A specific IgE to ovomucoid levels of 100 kU A /l predicted heated egg yolk‐positive OFC s for 38.3% of patients. Among 763 patients with a negative OFC , seven (0.9%) reacted to heated egg yolk at home, and 756 (99.1%) consumed hen's egg yolk safely. Conclusions Most pediatric patients allergic to heated hen's egg safely consumed heated egg yolk. Heated egg yolk OFC s rarely provoked severe symptoms and may be recommended for improving the QOL of children with allergy to hen's egg.