BSACI 2021 guideline for the management of egg allergy

Abstract

One in 50 children present with egg allergy. This is an update of the BSACI guideline for the management of egg allergy. 1 It was prepared by an expert group of the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and addresses the diagnosis and treatment of patients with egg allergy, for healthcare professionals working in secondary care. It includes guidance for families with egg-allergic children and adult egg-allergic patients. The guideline working group included paediatric and adult allergists, paediatric and adult allergy specialist dieticians and clinical psychologists working with egg-allergic patients. During development of this guideline, representatives from patient organizations (Allergy UK and Anaphylaxis Campaign) were part of the guideline writing group and involved in selection of topics, evidence, recommendations and draft reviews. Declarations of interest of the guideline lead and the writing group members are held at BSACI office and are available on request. None jeopardized unbiased guideline

BSACI 2021 guideline for the management of egg allergy

“…The guideline cites a number of hospital challenge series in support of the safety of home introduction. Specifically, it cites a 2% rate of anaphylaxis requiring adrenaline in 236 hospital‐based egg challenges 2 ; adrenaline was not required in another 181 hospital‐based egg challenges 3 ; and unpublished data where only two patients of 678 undergoing a hospital challenge who met the BSACI criteria for home reintroduction experienced airway symptoms 1 …”

“…The guideline does cite data from a series of 211 home-baked egg introductions where no anaphylaxis was seen but this is unpublished. 1 We would like to report our experience with the home reintroduction of egg in the Southampton paediatric allergy service. We undertook a service evaluation with a retrospective analysis of patients under 18 years old where home egg reintroduction was attempted from 2013 to 2020.…”

Food allergen ladders: A need for standardization

“…15 To date, four egg ladders for use in IgE-mediated food allergies have been published. The BSACI original egg ladder 16 and their recently updated ladder 15 consists of a number of main stages with many smaller steps, similar to the BSACI milk ladder. Thomas et al 17 published an egg ladder based on typical Australian food.…”

“…14 This was followed by a similar paper on IgE-mediated egg allergy by the BSACI. 15 To date, four egg ladders for use in IgE-mediated food allergies have been published. The BSACI original egg ladder 16 and their recently updated ladder 15 consists of a number of main stages with many smaller steps, similar to the BSACI milk ladder.…”

Corrigendum

“…In the article by Leech et al, 1 reference 94 was inadvertently added to the reference list and in‐text citation on page 1272.…”