Frontiers in Pediatrics (Jan 2021)

Avoidance of Hen's Egg Based on IgE Levels Should Be Avoided for Children With Hen's Egg Allergy

  • Yoshitsune Miyagi,
  • Yoshitsune Miyagi,
  • Kiwako Yamamoto-Hanada,
  • Hiroya Ogita,
  • Tomoyuki Kiguchi,
  • Yusuke Inuzuka,
  • Kenji Toyokuni,
  • Koji Nishimura,
  • Makoto Irahara,
  • Fumi Ishikawa,
  • Miori Sato,
  • Mayako Saito-Abe,
  • Yumiko Miyaji,
  • Shigenori Kabashima,
  • Tatsuki Fukuie,
  • Ichiro Nomura,
  • Yukihiro Ohya

DOI
https://doi.org/10.3389/fped.2020.583224
Journal volume & issue
Vol. 8

Abstract

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Background: Although hen's egg (HE) allergy was thought to be usually resolved by late childhood, majority of HE allergy patients with a high level of egg white (HEW)-specific IgE could not acquire tolerance for HE by age 8 years.Objective: The aim is to investigate whether the avoidance of HE until 6 years of age increased the risk of heated HE allergy at age 6 years.Methods: This was a retrospective case-control study. The HE tolerance children (n = 17) and children with low-dose HE reactor [a positive reaction to ≤ 4 g of heated HEW in oral food challenges (OFCs)] children (n = 26) were included based on the results of OFC at 6 years old. Multivariate logistic regression analysis was applied to examine the associations between HE avoidance until age 6 years and HE allergy status confirmed by OFC, adjusting the level of ovomucoid-specific IgE (OM-sIgE) during early infancy.Results: A lower proportion of strict avoidance of HE was observed in the HE tolerance group than in the low-dose HE reactor group (6 vs. 46%, p = 0.006). OM-sIgE levels in children younger than 2 years old were significantly higher in the low-dose HE reactor group than those in the HE tolerance group (median [interquartile], 26.7 UA/mL [11.9–53.4] vs. 7.9 UA/mL [0.35–23.4]; p =0.024). The avoidance of HE until 6 years of age increased the risk of heated HE allergy even after adjusting OM-sIgE levels.Conclusions: The long-term avoidance of HE from infancy increased the risk of heated HE allergy confirmed by OFC at age 6 years.

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