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. 2021 Jan;32(1):170-176.
doi: 10.1111/pai.13372. Epub 2020 Oct 10.

Safe egg yolk consumption after a negative result for low-dose egg oral food challenge

Noriyuki Yanagida  1 , Sakura Sato  2 , Kyohei Takahashi  1 , Tomoyuki Asaumi  1 , Ken-Ichi Nagakura  1 , Kiyotake Ogura  1 , Nobue Takamatsu  3 , Motohiro Ebisawa  2
Affiliations

Safe egg yolk consumption after a negative result for low-dose egg oral food challenge

Noriyuki Yanagida et al. Pediatr Allergy Immunol. 2021 Jan.

Abstract

Background: Hen's egg is one of the most common allergens causing infantile food allergy. Consuming heated egg yolk slightly contaminated with egg white (EY with scEW) improves diet quality. Most children with egg allergies can safely consume 1/25 of a heated whole egg (low-dose egg). Although low-dose egg has similar antigenicity to EY with scEW, clinical reproducibility is unknown. We aimed to examine the safety of EY with scEW consumption after a negative result of low-dose egg oral food challenge (OFC).

Methods: In this prospective study, children aged <18 years with a history of immediate reaction to eggs were enrolled. We advised children and guardians to consume EY with scEW after a negative result of low-dose egg OFC and to record symptoms, if any.

Results: We evaluated 276 children with negative results for low-dose egg OFC who had previously shown reactivity to eggs. Their median age was 1.2 years. Boys accounted for 188 (68%) of the children. The median egg white-specific immunoglobulin E level was 11.7 kUA /L. At home, six children experienced mild symptoms. Skin symptoms were the most common. Among the six children, five were confirmed to continue the consumption of EY with scEW and one developed mild respiratory symptoms and continued to avoid eating eggs.

Conclusion: Although a few children with egg allergies experience mild symptoms, most of them can ultimately consume EY with scEW. Consumption of EY with scEW after low-dose egg OFC seems safe and may improve their quality of life by making egg yolk products available.

Keywords: child; egg; egg yolk; food allergy; oral food challenge.

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Conflict of interest statement

Motohiro Ebisawa serves on the clinical medical advisory board of DBV Technologies. Sato Sakura and Motohiro Ebisawa have received speaker honoraria from Mylan EPD. All other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The amount of egg white contaminating the separated egg yolk. Egg yolk was separated manually with chalaza (n = 5), without chalaza (n = 5), and with an egg separator (n = 5) from one whole egg (approximately 50 g). The amount of egg white was 0.5‐1.9 g (equivalent to 62.5‐237.5 mg egg white protein)
Figure 2
Figure 2
Patient enrollment. Low‐dose oral food challenge (OFC) was administered. Among 495 children with egg allergies who previously reacted to eggs, 75 were excluded due to missing laboratory data or clinical information. The children who showed obvious symptoms (n = 89) and uncertain symptoms (n = 65) were excluded. We followed 276 children with negative results for low‐dose egg OFC who had previously reacted to eggs
See this image and copyright information in PMC

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