Allergy reaction mediated by Gal d 4 (lysozyme) after the induction of tolerance with egg

Infante, Sonsoles; López-Matas, M. Ángeles; Carnés, Jerónimo; Alonso, E.; Zapatero, Lydia

doi:10.1016/j.anai.2014.07.022

Cited by 3 publications

(1 citation statement)

References 4 publications

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“… Most egg allergens are found in egg white and are Gal d 1 (ovomucoid, being the main allergen, a thermo- and pepsin-resistant protein, marker of a possible severe allergic reaction [ 37 ]. Persistent specific IgE towards this component are associated with a greater risk of allergy persistence in adulthood and of subsequent sensitization to inhalants); Gal d 2 (ovalbumin, partially thermostable, well digested at very low pH) [ 38 ]; Gal d 3, (ovotransferrin, thermolabile, partially cross-reacting with chicken serum albumin) [ 39 ]; Gal d 4, (lysozyme, thermolabile on cooking over 80 °C for at least 2 minutes, often hidden allergen because used as additive for its bacteriostatic actions) [ 40 ]. The main specific allergens of the yolk are Gal d 5 (livetin, with possible cross-reactivity with livetin of the chicken) [ 41 ] and Gal d 6 (detected in many patients with yolk allergy) [ 42 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic therapeutic care pathway for pediatric food allergies and intolerances in Italy: a joint position paper by the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP)

et al. 2022

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Epidemiologic data suggest an increased prevalence of pediatric food allergies and intolerances (FAIs) during the last decades. This changing scenario has led to an increase in the overall healthcare costs, due to a growing demand for diagnostic and treatment services. There is the need to establish Evidence-based practices for diagnostic and therapeutic intervention that could be adopted in the context of public health policies for FAIs are needed.This joint position paper has been prepared by a group of experts in pediatric gastroenterology, allergy and nutrition from the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP). The paper is focused on the Diagnostic Therapeutic Care Pathway (DTCP) for pediatric FAIs in Italy.

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Section: Introductionmentioning

confidence: 99%

Diagnostic therapeutic care pathway for pediatric food allergies and intolerances in Italy: a joint position paper by the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP)

et al. 2022

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Bacitracin/muramidase/papain

2014

Reactions Weekly

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S Bacitracin/muramidase/papain IgE-mediated hypersensitivity reaction: case reportA 10-year-old girl developed IgE-mediated hypersensitivity reaction following administration of bacitracin/muramidase [lysozyme]/papain [Lizipaina].The girl, with hen egg allergy had a specific oral tolerance induction (SOTI) with hen's egg. Subsequently, she had a desensitization to cooked hen's egg. Nineteen months later, she experienced oral and pharyngeal pruritus with difficulty swallowing [duration of treatment to reaction onset not stated] after ingesting a bacitracin 3mg/muramidase 5mg/papain 2mg lozenge [indication not stated]. Her specific IgE to lysozyme was increased from 0.48 kUA/L before SOTI to 0.7 kUA/L after the IgE-mediated hypersensitivity reaction. She received dexchlorpheniramine and had a complete relief of symptoms. Skin prick test with hen's egg and individual proteins showed positive result.Author comment: "To summarize, we report the case of an IgE-mediated hypersensitivity reaction to lysozyme in a patient who achieved desensitization to cooked hen's egg after SOTI."

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Molecular diagnosis of egg allergy: an update

Chokshi¹,

Sicherer

2015

Expert Review of Molecular Diagnostics

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Hen's egg allergy affects up to 2.5% of young children and is potentially life-threatening. Several phenotypes of egg allergy have been identified, including those who tolerate extensively heated egg in bakery products. Diagnosis and monitoring for resolution often requires oral food challenges, which can result in anaphylaxis. Newer approaches, such as component-resolved diagnostics, microarray analysis and epitope mapping, are being evaluated to determine if these strategies can replace or reduce the need for oral food challenges. Studies suggest that elevated levels of ovomucoid IgE indicate an inability to tolerate extensively heated forms of egg. Egg protein-specific IgE/IgG4 ratios may be helpful in predicting tolerance. Additionally, patients with conformational epitopes to hen's egg are more likely to resolve their allergy compared with those with IgE binding to sequential epitopes. The pairing of microarray technology to epitope mapping is a potential tool to improve diagnosis. This review examines the current body of literature on these tools.

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Allergy reaction mediated by Gal d 4 (lysozyme) after the induction of tolerance with egg

Cited by 3 publications

References 4 publications

Diagnostic therapeutic care pathway for pediatric food allergies and intolerances in Italy: a joint position paper by the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP)

Diagnostic therapeutic care pathway for pediatric food allergies and intolerances in Italy: a joint position paper by the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP)

Bacitracin/muramidase/papain

Molecular diagnosis of egg allergy: an update

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