Dataset Information

The natural history of egg allergy in an observational cohort.

ABSTRACT:

Background

There are few studies on the natural history of egg allergy, and most are single-site and nonlongitudinal and have not identified early predictors of outcomes.

Objective

We sought to describe the natural course of egg allergy and to identify early prognostic markers.

Methods

Children age 3 to 15 months were enrolled in a multicenter observational study with either (1) a convincing history of an immediate allergic reaction to egg, milk, or both with a positive skin prick test (SPT) response to the trigger food and/or (2) moderate-to-severe atopic dermatitis and a positive SPT response to egg or milk. Children enrolled with a clinical history of egg allergy were followed longitudinally, and resolution was established based on successful ingestion.

Results

The cohort with egg allergy consists of 213 children followed to a median age of 74 months. Egg allergy resolved in 105 (49.3%) children at a median age of 72 months. Factors that were most predictive of resolution included the following: initial reaction characteristics (isolated urticaria/angioedema vs other presentations), baseline egg-specific IgE level, egg SPT wheal size, atopic dermatitis severity, IgG4 level, and IL-4 response (all P < .05). Numerous additional baseline clinical and demographic factors and laboratory assessments were not associated with resolution. Multivariate analysis identified baseline egg-specific IgE levels and initial reaction characteristics as strongly associated with resolution; a calculator to estimate resolution probabilities using these variables was established.

Conclusions

In this cohort of infants with egg allergy, approximately one half had resolved over 74 months of follow-up. Baseline egg-specific IgE levels and initial reaction characteristics were important predictors of the likelihood of resolution.

SUBMITTER: Sicherer SH

PROVIDER: S-EPMC3959659 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

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Publications

The natural history of egg allergy in an observational cohort.

Sicherer Scott H SH Wood Robert A RA Vickery Brian P BP Jones Stacie M SM Liu Andrew H AH Fleischer David M DM Dawson Peter P Mayer Lloyd L Burks A Wesley AW Grishin Alexander A Stablein Donald D Sampson Hugh A HA

The Journal of allergy and clinical immunology 20140201 2

<h4>Background</h4>There are few studies on the natural history of egg allergy, and most are single-site and nonlongitudinal and have not identified early predictors of outcomes.<h4>Objective</h4>We sought to describe the natural course of egg allergy and to identify early prognostic markers.<h4>Methods</h4>Children age 3 to 15 months were enrolled in a multicenter observational study with either (1) a convincing history of an immediate allergic reaction to egg, milk, or both with a positive ski ...[more]

PMID: 24636473

Similar Datasets

Project description:BackgroundImmune features of infants with food allergy have not been delineated.ObjectivesWe sought to explore the basic mechanisms responsible for food allergy and identify biomarkers, such as skin prick test (SPT) responses, food-specific IgE levels, and mononuclear cell responses, in a cohort of infants with likely milk/egg allergy at increased risk of peanut allergy.MethodsInfants aged 3 to 15 months were enrolled with a positive SPT response to milk or egg and either a corresponding convincing clinical history of allergy to milk or egg or moderate-to-severe atopic dermatitis. Infants with known peanut allergy were excluded.ResultsOverall, 512 infants (67% male) were studied, with 308 (60%) having a history of a clinical reaction. Skin test responses, detectable food-specific IgE, or both revealed sensitization as follows: milk, 78%; egg, 89%; and peanut, 69%. SPT responses and food-specific IgE levels were discrepant for peanut (15% for IgE > or = 0.35 kU(A)/L and negative SPT response vs 8% for positive SPT response and IgE <0.35 kU(A)/L, P = .001). Mononuclear cell allergen stimulation screening for CD25, cytokine-inducible SH2-containing protein (CISH), forkhead box protein 3 (FOXP3), GATA3, IL10, IL4, IFNG, and T-box transcription factor (TBET) expression by using casein, egg white, and peanut revealed that only allergen-induced IL4 expression was significantly increased in those with clinical allergy to milk (compared with nonallergic subjects) and in those sensitized to peanut, despite the absence of an increase in GATA3 mRNA expression.ConclusionsInfants with likely milk/egg allergy are at considerably high risk of having increased peanut-specific IgE levels (potential allergy). Peanut-specific serum IgE levels were a more sensitive indicator of sensitization than SPT responses. Allergen-specific IL4 expression might be a marker of allergic risk. Absence of an increase in GATA3 mRNA expression suggests that allergen-specific IL-4 might not be of T-cell origin.

Dataset Information

The natural history of egg allergy in an observational cohort.

Background

Objective

Methods

Results

Conclusions

Publications

The natural history of egg allergy in an observational cohort.

Similar Datasets

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