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Evaluation of baked egg oral immunotherapy in French children with hen's egg allergy
Author(s) -
Gruzelle Vianney,
Juchet Agnès,
MartinBlondel Audrey,
Michelet Marine,
ChabbertBroue Anne,
Didier Alain
Publication year - 2021
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.13437
Subject(s) - egg allergy , egg white , medicine , oral immunotherapy , oral food challenge , desensitization (medicine) , food allergy , anaphylactic reactions , anaphylaxis , allergy , immunoglobulin e , immunology , food science , antibody , biology , receptor
Background Introduction and gradual incremental escalation of a low dose of baked egg may accelerate the resolution of severe hen's egg (HE) allergy for some children. The purpose of our study was to evaluate the efficacy and safety of baked egg oral immunotherapy (OIT) in children with HE allergy after a low‐dose baked egg oral food challenge (OFC). Methods In a retrospective analysis of OFC performed between 2013 and 2018 at the Children's Hospital of Toulouse (France), we identified 71 children with HE allergy and high egg‐white (EW) and ovomucoid specific IgE levels, who underwent a total of 164 OFC (71 baked egg, then 93 unbaked egg). Mean age at first low‐dose baked egg OFC was 6 years. Median EW specific IgE was 14.0 kUA/L, and median ovomucoid specific IgE was 11.7 kUA/L. Results Most children were treated with baked egg OIT. Our study shows that 78.9% of the children did not react to first low‐dose baked egg OFC (702 mg of HE protein). 8.7% of children discontinued OIT at home. Finally, desensitization to unbaked HE was achieved in 47 children (66.2% of children allergic to HE). Children with lower EW specific IgE levels had a significantly higher probability of becoming desensitized to HE. We did not report any anaphylactic reactions to baked egg OIT. Conclusion Most children with HE allergy and high egg‐white (EW) and ovomucoïd specific IgE levels tolerate the introduction of baked egg. Baked egg OIT is safe, and anaphylaxis to baked egg OIT has not been observed.