Egg allergy: An update (original) (raw)

Abstract

Egg allergy is the commonest infant food allergy both in Australia and worldwide. The clinical presentation of egg allergy is varied-egg is involved in both IgE and non-IgE-mediated allergic reactions and has been implicated in conditions such as anaphylaxis, food proteininduced enterocolitis syndrome, atopic dermatitis and eosinophilic oesophagitis. The clinical presentation, pathophysiology and diagnosis as well as the natural history and management of egg allergy will be discussed. Current theories about primary prevention as well as potential future therapies are presented. Finally, practical information about egg allergy and immunisation is provided.

Loading...

Loading Preview

Sorry, preview is currently unavailable. You can download the paper by clicking the button above.

References (42)

  1. Rona RJ, Keil T, Summers C et al. The prevalence of food allergy: a meta-analysis. J. Allergy Clin. Immunol. 2007; 120: 638-46.
  2. Osborne NJ, Koplin JJ, Martin PE et al. Prevalence of challenge-proven IgE-mediated food allergy using population-based sampling and predetermined challenge criteria in infants. J. Allergy Clin. Immunol. 2011; 127: 668-76 e1-2.
  3. Miller H, Campbell DH. Skin test reactions to various chemical fractions of egg white and their possible clinical significance. J. Allergy 1950; 21: 522-4.
  4. Bleumink E, Young E. Studies on the atopic allergen in hen's egg. II. Further characterization of the skin-reactive fraction in egg-white; immuno-electrophoretic studies. Int. Arch. Allergy Appl. Immunol. 1971; 40: 72-88.
  5. Cooke SK, Sampson HA. Allergenic properties of ovomucoid in man. J. Immunol. 1997; 159: 2026-32.
  6. Boyano Martinez T, Garcia-Ara C, Diaz-Pena JM, Munoz FM, Garcia Sanchez G, Esteban MM. Validity of specific IgE antibodies in children with egg allergy. Clin. Exp. Allergy 2001; 31: 1464-9.
  7. Macdougall CF, Cant AJ, Colver AF. How dangerous is food allergy in childhood? The incidence of severe and fatal allergic reactions across the UK and Ireland. Arch. Dis. Child. 2002; 86: 236-9.
  8. Mehl A, Wahn U, Niggemann B. Anaphylactic reactions in children-a questionnaire-based survey in Germany. Allergy 2005; 60: 1440-5.
  9. 9 Liew WK, Williamson E, Tang ML. Anaphylaxis fatalities and admissions in Australia. J. Allergy Clin. Immunol. 2009; 123: 434-42.
  10. Pumphrey R. Anaphylaxis: can we tell who is at risk of a fatal reaction? Curr. Opin. Allergy Clin. Immunol. 2004; 4: 285-90.
  11. Bock SA, Munoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J. Allergy Clin. Immunol. 2001; 107: 191-3.
  12. Tewari A, Du Toit G, Lack G. The difficulties of diagnosing food-dependent exercise-induced anaphylaxis in childhood -a case study and review. Pediatr. Allergy Immunol. 2006; 17: 157-60.
  13. Leonard SA, Nowak-Wegrzyn A. Re-defining food allergy phenotypes and management paradigm: is it time for individualized egg allergy management? Clin. Exp. Allergy 2011; 41: 609-11.
  14. Lemon-Mule H, Sampson HA, Sicherer SH, Shreffler WG, Noone S, Nowak-Wegrzyn A. Immunologic changes in children with egg allergy ingesting extensively heated egg. J. Allergy Clin. Immunol. 2008; 122: 977-83 e1.
  15. Konstantinou GN, Giavi S, Kalobatsou A et al. Consumption of heat-treated egg by children allergic or sensitized to egg can affect the natural course of egg allergy: hypothesis-generating observations. J. Allergy Clin. Immunol. 2008; 122: 414-15.
  16. Des Roches A, Nguyen M, Paradis L, Primeau MN, Singer S. Tolerance to cooked egg in an egg allergic population. Allergy 2006; 61: 900-1.
  17. Nowak-Wegrzyn A, Fiocchi A. Rare, medium, or well done? The effect of heating and food matrix on food protein allergenicity. Curr. Opin. Allergy Clin. Immunol. 2009; 9: 234-7.
  18. Du Toit G, Roberts G, Sayre PH et al. Identifying infants at high risk of peanut allergy: the Learning Early About Peanut Allergy (LEAP) screening study. J. Allergy Clin. Immunol. 2013; 131: 135-43 e1-12.
  19. Osterballe M, Bindslev-Jensen C. Threshold levels in food challenge and specific IgE in patients with egg allergy: is there a relationship? J. Allergy Clin. Immunol. 2003; 112: 196-201.
  20. Celik-Bilgili S, Mehl A, Verstege A et al. The predictive value of specific immunoglobulin E levels in serum for the outcome of oral food challenges. Clin. Exp. Allergy 2005; 35: 268-73.
  21. Ando H, Moverare R, Kondo Y et al. Utility of ovomucoid-specific IgE concentrations in predicting symptomatic egg allergy. J. Allergy Clin. Immunol. 2008; 122: 583-8.
  22. Kemp AS, Allen CW, Campbell DE. Parental perceptions in egg allergy: does egg challenge make a difference? Pediatr. Allergy Immunol. 2009; 20: 648-53.
  23. Langeland T. A clinical and immunological study of allergy to hen's egg white. IV. Specific IGE-antibodies to individual allergens in hen's egg white related to clinical and immunological parameters in egg-allergic patients. Allergy 1983; 38: 493-500.
  24. Quirce S, Maranon F, Umpierrez A, de las Heras M, Fernandez-Caldas E, Sastre J. Chicken serum albumin (Gal d 5*) is a partially heat-labile inhalant and food allergen implicated in the bird-egg syndrome. Allergy 2001; 56: 754-62.
  25. Leonard SA, Sampson HA, Sicherer SH et al. Dietary baked egg accelerates resolution of egg allergy in children. J. Allergy Clin. Immunol. 2012; 130: 473-80 e1.
  26. Burks AW, Jones SM, Wood RA et al. Oral immunotherapy for treatment of egg allergy in children. N. Engl. J. Med. 2012; 367: 233-43.
  27. Boyano-Martinez T, Garcia-Ara C, Diaz-Pena JM, Martin-Esteban M. Prediction of tolerance on the basis of quantification of egg white-specific IgE antibodies in children with egg allergy. J. Allergy Clin. Immunol. 2002; 110: 304-9.
  28. Savage JH, Matsui EC, Skripak JM, Wood RA. The natural history of egg allergy. J. Allergy Clin. Immunol. 2007; 120: 1413-17.
  29. Shek LP, Soderstrom L, Ahlstedt S, Beyer K, Sampson HA. Determination of food specific IgE levels over time can predict the development of tolerance in cow's milk and hen's egg allergy. J. Allergy Clin. Immunol. 2004; 114: 387-91.
  30. Breuer K, Heratizadeh A, Wulf A et al. Late eczematous reactions to food in children with atopic dermatitis. Clin. Exp. Allergy 2004; 34: 817-24.
  31. Lever R, MacDonald C, Waugh P, Aitchison T. Randomised controlled trial of advice on an egg exclusion diet in young children with atopic eczema and sensitivity to eggs. Pediatr. Allergy Immunol. 1998; 9: 13-19.
  32. Liacouras CA, Spergel JM, Ruchelli E et al. Eosinophilic esophagitis: a 10-year experience in 381 children. Clin. Gastroenterol. Hepatol. 2005; 3: 1198-206.
  33. Noel RJ, Putnam PE, Rothenberg ME. Eosinophilic esophagitis. N. Engl. J. Med. 2004; 351: 940-1.
  34. Caubet JC, Nowak-Wegrzyn A. Food protein-induced enterocolitis to hen's egg. J. Allergy Clin. Immunol. 2011; 128: 1386-8.
  35. Hsu P, Mehr S. Egg: a frequent trigger of food protein-induced enterocolitis syndrome. J. Allergy Clin. Immunol. 2013; 131: 241-2.
  36. Kondo M, Fukao T, Omoya K et al. Protein-losing enteropathy associated with egg allergy in a 5-month-old boy. J. Investig. Allergol. Clin. Immunol. 2008; 18: 63-6.
  37. Kramer MS, Kakuma R. Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Cochrane Database Syst. Rev. 2012; (9): CD000133.
  38. Koplin JJ, Osborne NJ, Wake M et al. Can early introduction of egg prevent egg allergy in infants? A population-based study. J. Allergy Clin. Immunol. 2010; 126: 807-13.
  39. James JM, Burks AW, Roberson PK, Sampson HA. Safe administration of the measles vaccine to children allergic to eggs. N. Engl. J. Med. 1995; 332: 1262-6.
  40. Mullins RJ, Gold MS. Influenza vaccination of the egg-allergic individual. Med. J. Aust. 2011; 195: 52-3.
  41. Kelso JM, Mootrey GT, Tsai TF. Anaphylaxis from yellow fever vaccine. J. Allergy Clin. Immunol. 1999; 103: 698-701.
  42. Murphy A, Campbell DE, Baines D, Mehr S. Allergic reactions to propofol in egg-allergic children. Anesth. Analg. 2011; 113: 140-4.