Is it possible to make a diagnosis of raw, heated, and baked egg allergy in children using cutoffs? A systematic review

  title={Is it possible to make a diagnosis of raw, heated, and baked egg allergy in children using cutoffs? A systematic review},
  author={Mauro Calvani and Stefania Arasi and Annamaria Bianchi and Davide Caimmi and Barbara Cuomo and Arianna Dondi and Giovanni Cosimo Indirli and Stefania La Grutta and Valentina Panetta and Maria Carmen Verga},
  journal={Pediatric Allergy and Immunology},
  pages={509 - 521}
The diagnosis of IgE‐mediated egg allergy lies both on a compatible clinical history and on the results of skin prick tests (SPTs) and IgEs levels. Both tests have good sensitivity but low specificity. For this reason, oral food challenge (OFC) is the ultimate gold standard for the diagnosis. The aim of this study was to systematically review the literature in order to identify, analyze, and synthesize the predictive value of SPT and specific IgEs both to egg white and to main egg allergens and… 

Specific IgE levels as an outcome predictor in egg-allergic children.

IgE-specific concentrations are useful as predictors of OFC outcome and should be considered when selecting patients challenge testing with boiled or raw egg, however, patients should undergo OFC with baked egg regardless of IgE levels.

Oral Food Challenge

This review does not intend to analyse comprehensively all the issues related to the diagnosis of food allergies, but to summarize some practical information on the OFC procedure, as reported in a recent issue by The Expert Review of Food Allergy Committee of Italian Society of Pediatric Allergy and Immunology.

Utility of fresh egg skin prick test and egg-yolk specific IgE for outgrowth.

Role of in vitro testing in food allergy

  • S. ArasiS. Barni D. Caimmi
  • Medicine
    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
  • 2020
In vitro tests used for the diagnosis of food allergy include the basophil activation test, that is becoming more and more employed by clinicians and not only by researchers, and the evaluation of serum IgG4, which is still an issue of debate in the allergy community.

Tolerance of a high-protein baked-egg product in egg-allergic children.

Food allergy: an updated review on pathogenesis, diagnosis, prevention and management

In the diagnostic pathway of FA an important recent innovation is the CRD introduction which resulted in the possibility of improving diagnostic accuracy through FA prediction severity and prognosis and thereby decreasing the OCF necessity.

Component-Resolved Diagnosis in Food Allergies

The aim of this review is to summarize the most relevant concepts in the field of CRD in food allergy and to provide a practical approach useful in clinical practice.

New approach for food allergy management using low-dose oral food challenges and low-dose oral immunotherapies.

Are there any biomarkers that can predict tolerance to baked egg in egg allergic children younger than 6 years?

  • A. MachinenaC. Riggioni M. Álvaro
  • Medicine
    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
  • 2019
The prevalence of food allergy is increasing worldwide; it is estimated that around 2% of preschoolers suffer from food allergy, and perception of children's quality of life is affected by the duration of the exclusion diet.

Daily baked egg intake may accelerate the development of tolerance to raw egg in egg-allergic children

Daily intake of BE in BE-tolerant children accelerates tolerance to raw egg, and patients who tolerated BE on diagnosis and followed an exclusion diet show a similar evolution than patients who initially did not tolerate BE.



Role of specific IgE and skin-prick testing in predicting food challenge results to baked egg

Based on a retrospective chart review of children, aged 2-18 years, receiving an egg white-specific IgE level, skin-prick test (SPT), and OFC to baked egg, SPT, and age are not good predictors of passing a baked egg challenge, but there was a trend for more predictability with SPT wheal size.

Skin prick testing with extensively heated milk or egg products helps predict the outcome of an oral food challenge: a retrospective analysis

SPT with EH milk or egg products was predictive of a successful OFC to the same food, and larger prospective studies are required to substantiate these findings.

Molecular diagnosis of egg allergy

Using recombinant allergens, IgE-binding epitopes, and microarrays, molecular-based technologies show promising results, however, none of these tests is ready to be used in clinical practice and oral food challenge remains the standard for the diagnosis of egg allergy.

Atopy patch tests, together with determination of specific IgE levels, reduce the need for oral food challenges in children with atopic dermatitis.

The combination of positive APT results and measurement of levels of specific IgE makes double-blind, placebo-controlled, food challenges superfluous for suspected CM and HE allergy.

Position document: IgE-mediated allergy to egg protein.

Threshold levels in food challenge and specific IgE in patients with egg allergy: is there a relationship?

The purpose of this study was to determine the utility of specific IgE in estimating threshold level to predict a positive outcome in food challenge and found no significant relationship between thespecific IgE concentration (egg white) and the challenge threshold level.

The atopy patch test in the diagnostic workup of suspected food-related symptoms in children.

The diagnostic value of skin prick testing in children with food allergy

  • D. HillR. HeineC. Hosking
  • Medicine
    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
  • 2004
Assessment of the diagnostic agreement between food‐specific immunoglobulin E (IgE) antibody levels and SPT in a cohort of 820 infants and children under 2 yr of age with suspected allergy to cow milk, egg or peanut found SPT was more sensitive in diagnosing allergy to egg and peanut.

The Clinical Usefulness of IgE Antibodies Against Egg White and Its Components in Korean Children

The results show that the sensitivity and specificity of the predictive decision point values for egg white-sIgE antibodies by ImmunoCAP were relatively low in Korean children, and careful personal history recording and challenge tests are necessary for the correct diagnosis of an egg allergy.

Utility of food-specific IgE concentrations in predicting symptomatic food allergy.

  • H. Sampson
  • Medicine
    The Journal of allergy and clinical immunology
  • 2001
Quantification of food-specific IgE is a useful test for diagnosing symptomatic allergy to egg, milk, peanut, and fish in the pediatric population and could eliminate the need to perform double-blind, placebo-controlled food challenges in a significant number of children.