Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Σάββατο 21 Ιουλίου 2018

Differences in egg and milk food challenge outcomes based on tolerance to the baked form

Publication date: Available online 21 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Peter Capucilli, Antonella Cianferoni, Joel Fiedler, Laura Gober, Nicholas Pawlowski, Gita Ram, Rushani Saltzman, Jonathan M. Spergel, Jennifer Heimall

Abstract
Background

Previous studies suggest inclusion of baked egg and milk in the diet of egg or cow's milk (CM) allergic children may positively impact native tolerance. Differences in native food reactivity based on historical baked tolerance, however, is not fully understood. Objective: To assess differences in native egg and CM oral food challenge (OFC) outcomes based on presenting history of tolerance and exposure to these foods in the baked form.

Methods

Retrospective review of all egg and CM OFCs at The Children's Hospital of Philadelphia, Philadelphia, PA, over 4 years (n=580). History of baked ingestion was compared to OFC pass rate, eliciting dose, epinephrine use, reaction classification and recent skin test or specific IgE level.

Results

There were 115 egg and 70 CM positive challenges with most eliciting anaphylaxis. Children tolerating baked egg passed OFC more frequently (75%), compared to children who avoided baked egg (58%) (P=0.01) or never ingested egg (45%) (P<0.0001). For positive reactions, baked egg tolerant children reacted at higher eliciting doses of native egg (Median 3.0g, Range 0.125-15.75g) compared to those avoiding baked egg (Median 0.69g, Range 0.13-10.0g) (P=0.03) and those with no egg exposure (Median 0.88g, Range 0.13-13.88g) (P=0.01). Further, epinephrine use was lower in children tolerating baked egg (10%) compared to children avoiding baked egg (22%) (P=0.02) and compared to subjects who never ingested egg (32%) (P=0.0001). These differences were not observed for CM challenges.

Conclusion

Children who historically tolerated baked egg were less sensitive to native egg during OFC compared to children whose baked reactivity was largely unknown.



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