Phenotypes of persistent hen`s egg allergy in children and adolescents

Background. Optimum management of food allergy (FA) includes consideration of co-allergies and multimorbidities and tolerance assessment. Documentation of FA practices may pave the way for better practice. Methods. Patients aged 3-18 years, with persistent IgE-mediated hen`s egg allerg...

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Main Authors: Hilal Ünsal, Sevda Tüten Dal, Ayşegül Akarsu, Ümit Murat Şahiner, Özge Soyer, Bülent Enis Şekerel
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2023-02-01
Series:The Turkish Journal of Pediatrics
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Online Access:https://turkjpediatr.org/article/view/2
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author Hilal Ünsal
Sevda Tüten Dal
Ayşegül Akarsu
Ümit Murat Şahiner
Özge Soyer
Bülent Enis Şekerel
author_facet Hilal Ünsal
Sevda Tüten Dal
Ayşegül Akarsu
Ümit Murat Şahiner
Özge Soyer
Bülent Enis Şekerel
author_sort Hilal Ünsal
collection DOAJ
description Background. Optimum management of food allergy (FA) includes consideration of co-allergies and multimorbidities and tolerance assessment. Documentation of FA practices may pave the way for better practice. Methods. Patients aged 3-18 years, with persistent IgE-mediated hen`s egg allergy were reviewed. Results. A total of 102 children with a median age of 59 months (IQR= 40-84) (72.2% males) were included. All were diagnosed during infancy and the initial symptoms were atopic dermatitis (65.6%), urticaria (18.6%), and anaphylaxis (5.9%). Of the total population, 21 (20.6%) experienced anaphylaxis with hen`s eggs, and 79.4%, 89.2%, and 30.4% had multiple FAs (≥2 food categories), ever atopic dermatitis, and asthma, respectively. The most common co-allergies were tree nuts, cow`s milk, and seeds, respectively. From 52 heated egg yolk and 47 baked egg oral food challenges, 48 (92.3%) and 41 (87.2%) were found as tolerant, respectively. The baked egg nontolerant group had a greater egg white skin prick test diameter [9 mm (IQR: 6-11.5) vs. 6 mm (IQR: 4.5-9); (p=0.009)] and specific IgE [12.6 kU/L (IQR: 4.11-45.4) vs. 6.2 kU/L (IQR: 1.9-12.4) (p=0.009)], respectively. In the multivariate analysis, baked egg tolerance was more likely in those with egg yolk-tolerant subgroup (OR: 6.480, 95% CI: 2.524-16.638; p < 0.001) and heated egg tolerance in those with baked egg tolerance (OR: 6.943, 95% CI: 1.554-31.017; p=0.011). Conclusions. Persistent hen`s egg allergy is characterized by multiple food allergies and age-related multimorbidities. Baked egg and heated egg yolk tolerance were more likely to be considered in a subgroup with a high expectation for finding a way to eliminate their allergy.
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publisher Hacettepe University Institute of Child Health
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spelling doaj-art-80fd7530e73543128237c60743bef6152025-08-20T02:17:50ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212023-02-0165110.24953/turkjped.2021.5417Phenotypes of persistent hen`s egg allergy in children and adolescentsHilal Ünsal0Sevda Tüten Dal1Ayşegül Akarsu2Ümit Murat Şahiner3Özge Soyer4Bülent Enis Şekerel5Division of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Türkiye.Division of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Türkiye.Division of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Türkiye.Division of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Türkiye.Division of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Türkiye.Division of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Türkiye. Background. Optimum management of food allergy (FA) includes consideration of co-allergies and multimorbidities and tolerance assessment. Documentation of FA practices may pave the way for better practice. Methods. Patients aged 3-18 years, with persistent IgE-mediated hen`s egg allergy were reviewed. Results. A total of 102 children with a median age of 59 months (IQR= 40-84) (72.2% males) were included. All were diagnosed during infancy and the initial symptoms were atopic dermatitis (65.6%), urticaria (18.6%), and anaphylaxis (5.9%). Of the total population, 21 (20.6%) experienced anaphylaxis with hen`s eggs, and 79.4%, 89.2%, and 30.4% had multiple FAs (≥2 food categories), ever atopic dermatitis, and asthma, respectively. The most common co-allergies were tree nuts, cow`s milk, and seeds, respectively. From 52 heated egg yolk and 47 baked egg oral food challenges, 48 (92.3%) and 41 (87.2%) were found as tolerant, respectively. The baked egg nontolerant group had a greater egg white skin prick test diameter [9 mm (IQR: 6-11.5) vs. 6 mm (IQR: 4.5-9); (p=0.009)] and specific IgE [12.6 kU/L (IQR: 4.11-45.4) vs. 6.2 kU/L (IQR: 1.9-12.4) (p=0.009)], respectively. In the multivariate analysis, baked egg tolerance was more likely in those with egg yolk-tolerant subgroup (OR: 6.480, 95% CI: 2.524-16.638; p < 0.001) and heated egg tolerance in those with baked egg tolerance (OR: 6.943, 95% CI: 1.554-31.017; p=0.011). Conclusions. Persistent hen`s egg allergy is characterized by multiple food allergies and age-related multimorbidities. Baked egg and heated egg yolk tolerance were more likely to be considered in a subgroup with a high expectation for finding a way to eliminate their allergy. https://turkjpediatr.org/article/view/2Hen`s eggadolescentsallergyatopic dermatitischildren
spellingShingle Hilal Ünsal
Sevda Tüten Dal
Ayşegül Akarsu
Ümit Murat Şahiner
Özge Soyer
Bülent Enis Şekerel
Phenotypes of persistent hen`s egg allergy in children and adolescents
The Turkish Journal of Pediatrics
Hen`s egg
adolescents
allergy
atopic dermatitis
children
title Phenotypes of persistent hen`s egg allergy in children and adolescents
title_full Phenotypes of persistent hen`s egg allergy in children and adolescents
title_fullStr Phenotypes of persistent hen`s egg allergy in children and adolescents
title_full_unstemmed Phenotypes of persistent hen`s egg allergy in children and adolescents
title_short Phenotypes of persistent hen`s egg allergy in children and adolescents
title_sort phenotypes of persistent hen s egg allergy in children and adolescents
topic Hen`s egg
adolescents
allergy
atopic dermatitis
children
url https://turkjpediatr.org/article/view/2
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AT aysegulakarsu phenotypesofpersistenthenseggallergyinchildrenandadolescents
AT umitmuratsahiner phenotypesofpersistenthenseggallergyinchildrenandadolescents
AT ozgesoyer phenotypesofpersistenthenseggallergyinchildrenandadolescents
AT bulentenissekerel phenotypesofpersistenthenseggallergyinchildrenandadolescents