Journal Article10.1016/J.ANAI.2018.07.018
Differences in egg and milk food challenge outcomes based on tolerance to the baked form.
Peter Capucilli,Peter Capucilli,Antonella Cianferoni,Joel Fiedler,Laura Gober,Nicholas A. Pawlowski,Gita Ram,Rushani W. Saltzman,Jonathan M. Spergel,Jennifer Heimall +9 more
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TL;DR: Children who historically tolerated baked egg were less sensitive to native egg during OFC compared with children whose baked reactivity was largely unknown.
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Abstract: Background Previous studies suggest inclusion of baked egg and milk in the diet of children with egg or cow's milk (CM) allergy might positively affect native tolerance. However, differences in native food reactivity based on historical baked tolerance are 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 This study is a retrospective review of all egg and CM OFCs at the Children's Hospital of Philadelphia (Philadelphia, Pennsylvania) over 4 years (N = 580). History of baked ingestion was compared with OFC pass rate, eliciting dose, epinephrine use, reaction classification, and recent skin test reaction or specific immunoglobulin E level. Results There were 115 egg- and 70 CM-positive challenge reactions, with most eliciting anaphylaxis. Children tolerating baked egg passed OFC more frequently (75%) compared with children who avoided baked egg (58%; P = .01) or never ingested egg (45%; P Conclusion Children who historically tolerated baked egg were less sensitive to native egg during OFC compared with children whose baked reactivity was largely unknown.
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Citations
Egg Allergy in US Children.
Waheeda Samady,Waheeda Samady,Christopher M. Warren,Christopher M. Warren,Julie Wang,Rajeshree Das,Ruchi Gupta,Ruchi Gupta +7 more
TL;DR: Increased efforts are needed to ensure children with egg allergy are appropriately evaluated as many have comorbid allergic disease and determination of baked egg tolerance may improve QoL.
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Delayed and Severe Reactions to Baked Egg and Baked Milk Challenges.
TL;DR: BE and BM challenge reactions differed phenotypically from other OFC reactions, including significantly increased frequencies of new symptoms beginning >60 min. after challenge termination.
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Egg allergy in us children
W. Samady,Rajeshree Das,J. Ross,Christopher M. Warren,Jialing Jiang,Bridget Smith,Ruchi Gupta +6 more
TL;DR: Efforts to increase physician diagnosis of egg allergy, including evaluation for baked egg, can significantly improve quality of life and over one third of patients with egg allergy can tolerate baked egg.
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Rostrum: Are There Hidden Dangers Associated with Milk and Egg Dietary Advancement Therapy?
TL;DR: In this article , the authors discuss practical concerns about the safety of DAT, and considerations regarding how clinicians can maximize patient protection while defining the safety and efficacy of real world implementation of real-world implementation of these concepts.
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Role of FOXP3 Expression and Serum Vitamin D and C Concentrations When Predicting Acquisition of Tolerance in Infants With Cow's Milk Allergy.
I Sardecka-Milewska,Ewa Łoś-Rycharska,Julia Gawryjołek,Ewa Toporowska-Kowalska,Aneta Krogulska +4 more
TL;DR: Increased FOXP3 mRNA expression can predict faster acquisition of tolerance in infants with CMA, which have lower serum vitamin D levels than healthy children.
References
Ovomucoid Is Not Superior to Egg White Testing in Predicting Tolerance to Baked Egg
Lisa M. Bartnikas,Lisa M. Bartnikas,William J. Sheehan,William J. Sheehan,Katherine Larabee,Carter R. Petty,Lynda C. Schneider,Lynda C. Schneider,Wanda Phipatanakul,Wanda Phipatanakul +9 more
TL;DR: Most children with egg allergy in this study passed baked egg challenges and ovomucoid sIgE, although a useful clinical predictor of baked egg tolerance, was not superior to egg white skin prick test (SPT) wheal size with baked egg challenge outcome.
The Impact of Baked Egg and Baked Milk Diets on IgE- and Non-IgE-Mediated Allergy.
Julia Upton,Anna Nowak-Wegrzyn +1 more
TL;DR: There is currently no evidence for prevention of allergy with the baked diets, but a future role for BM and BE in liberating the diets of individuals with non-IgE-mediated allergy given recent studies that a subset of these patients can consume BM without a clinical reaction.
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Correlation of initial food reactions to observed reactions on challenges
Jonathan M. Spergel,Janet L Beausoleil,Joel Fiedler,Julie Ginsberg,Kyle Wagner,Nicholas A. Pawlowski +5 more
TL;DR: Milk, egg, and peanut are the most common foods associated with food challenges, and multiple-organ system reactions can occur after any initial clinical presentation, with milk, egg and peanut having more multiple- Organ system reactions than other foods.
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Debates in allergy medicine: baked milk and egg ingestion accelerates resolution of milk and egg allergy
TL;DR: The current understanding of baked milk and egg tolerance is reviewed and how these baked forms accelerates tolerance to regular milk and bird’s egg is outlined.
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Baked Milk and Egg Diets for Milk and Egg Allergy Management.
TL;DR: Further research is needed on biomarkers that can predict baked milk or egg reactivity; however, data suggest casein- and ovomucoid-specific immunoglobulin E levels may be useful.
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