Outcomes of Baked Milk and Egg Challenge in Cow’s Milk and Hen’s Egg Allergy: Can Tolerance Be Predicted with Allergen-Specific IgE and Prick-to-Prick Test?

Köse, Seda Şirin; Asilsoy, Suna; Uzuner, Nevin; Karaman, Özkan; Anal, Özden

doi:10.1159/000502957

Cited by 23 publications

(21 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Research has shown that 65-83% of children with milk allergies can safely consume baked-milk products. [8][9][10][16][17][18][19][20][21][22][23] Notably, Cherkaoui et al 21 detected a positive rate of 23% in patients with CM allergy in oral provocation tests performed with baked milk. Nowak-Wegrzyn et al, 8 who used muffins and waffles containing baked milk, reported an identical positive rate of 23%.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of some predictive parameters for baked milk tolerance in children with cow's milk allergy

Kılıç

Çilkol

Taşkın

2021

aei

View full text Add to dashboard Cite

Background: Inclusion of baked-milk products to the diet appears to markedly accelerate tolerance to unheated milk compared to a strict avoidance diet.Objective: The present study aims to investigate the predictors of baked-milk tolerance in children with Immunoglobulin E (IgE)-mediated cow’s milk (CM) allergy.Methods: The study included 80 patients diagnosed with IgE-mediated CM allergy upon oral food challenge (OFC) testing at our clinic. Patients who developed and did not develop reactions during OFC with baked milk were compared considering clinical and laboratory parameters.Results: Eighty patients with CM allergy comprised 48 male and 32 female infants with an average age of 7.25 ± 2.45 (3–13) months. We found that 62.5% of them showed tolerance to baked milk in the OFC test performed with cakes containing 2.6-g milk protein. When the patients who tolerated and could not tolerate baked-milk products were compared for test results, we detected a statistically significant intergroup difference regarding diameter of wheal in skin prick test (SPT) performed with muffin slurry, levels of specific Immunoglobulin E (sIgE) in CM, sheep’s milk (SM), goat’s milk (GM), casein, and the amount of unheated milk consumed until a reaction developed in the OFC test performed with unheated milk (P < 0.05).Conclusion: We defined novel decision points based on CM, SM, GM, casein sIgE levels, wheal diameter in SPT with muffin slurry, and the amount of milk ingested during OFC performed with unheated milk that may be useful in predicting outcomes of baked-milk ingestion.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of some predictive parameters for baked milk tolerance in children with cow's milk allergy

Kılıç

Çilkol

Taşkın

2021

aei

View full text Add to dashboard Cite

show abstract

“…The food that causes IgE-mediated food allergy varies according to the nutritional habits of the population. The most common food-allergy type in our country is the allergies emerging after cow's milk and eggs (7,8). Milk and egg allergy in children is a common cause of anaphylactic reactions.…”

Section: Msdmentioning

confidence: 99%

Is it possible to predict the development of anaphylaxis before oral food challenge tests administered to evaluate tolerance in IgE-mediated food allergy in children?

Asilsoy

Tezcan

et al. 2022

Med Sci Discov

Self Cite

View full text Add to dashboard Cite

Objective: Life-threatening anaphylaxis may occur in IgE-mediated food allergy. Oral Food Challenge (OFC) is the gold standard in demonstrating tolerance and diagnosing food allergy; however, these tests may cause anaphylaxis. Predicting the risk of developing anaphylaxis before performing OFC is valuable information in evaluating tolerance as in diagnosis. The present study aims to evaluate the effectiveness of the tests used in clinical practice in predicting the risk of anaphylaxis during OFC in IgE-mediated food allergy. To our knowledge, this is the first study evaluating skin prick tests in the prediction of anaphylaxis. Material and Methods: In this descriptive cross-sectional study, the history, demographic, clinical and laboratory data of the patients, followed up with the diagnosis of IgE-mediated food allergy, on whom OFC was performed, were evaluated retrospectively. Results: Of the 254 patients who underwent OFC, 133 were followed up with a diagnosis of IgE-mediated food allergy. The mean age was 21 months (12-120), and anaphylaxis occurred in nine (6.7%) of them during OFC. According to the frequency, the food responsible for IgE-mediated food allergy was determined as milk, egg and egg-milk combination. Age during the challenge and total IgE levels were higher in the group that experienced OFC-related anaphylaxis. The tests that could best determine the risk of anaphylaxis before the challenge was the skin prick test (SPT) and prick to prick (PTP) test for milk. Milk SPT and PTP test at the time of initial diagnosis and determination of milk sIgE and egg white sIgE before challenge were found to predict the risk of anaphylaxis. The negative predictive value was over 95% in tests that gave significant results for milk. There was no statistically significant finding associated with other allergenic foods. Conclusion: In evaluating tolerance development, performing sIgE, SPT and/or PTP tests for milk before OFC is useful in predicting anaphylaxis. Studies with larger numbers of cases are needed to assess the risk of anaphylaxis caused by other foods.

show abstract

“…In the present study, we found that children with persistent milk allergies were more likely to have persistent EAs, which, in part, coincided with study from Sicherer 20 , which suggests that persistent milk allergy may be used as a time predictor of EA tolerance. Kose et al 24 have conducted a retrospective study and found that at the end of 6 months of consuming baked hen's egg (BE), the scrambled egg tolerance was negatively associated with EW-specific IgE levels, EW SPT, and the EW prick-to-prick test (PTP). EW PTP was the most significant parameter 22 .…”

Section: Risk Factors For the Outcome Of Eamentioning

confidence: 99%

Predictive factors of egg allergy clinical outcomes in infants and young children

Shao

2022

Preprint

View full text Add to dashboard Cite

Aim: The aim of the present study was to explore the tolerance march in children and establish probable factors that affect the prognosis of an egg allergy (EA). Methods: Two hundred children 6 months to 2.5 years old with atopic dermatitis (AD) were recruited into our study from 2018 to 2019. EA was diagnosed based on medical history, the skin prick test (SPT), and the oral food challenge test (OFC) ,EA was diagnosed in 78，among those, 7 were allergic only to egg yolk (OnlyEYA), 20 to egg white (OnlyEWA), and 51 to whole egg (WEA). Logistic regression analysis was used to detect the disease course and related risk factors of outcomes. The receiver operating characteristic curve was used to establish a predicting model. Results:The Scoring Atopic Dermatitis score in the WEA group was more severe and persistent than that in the other groups. Forty-three cases of EA developed clinical tolerance (average age, 32.3 ± 8.7 months). The tolerance rate of EYA was 75.9% and EWA was 56.3%. The SPT wheal diameter at initial diagnosis (SPT ) was the risk factor for persistent EA. The SPT wheal diameter after 6 months (△SPT ) in the tolerant group decreased markedly compared to that in the persistent EA group. Tolerance was higher when △EW-SPT ≥ 39.5% or △EY-SPT ≥ 27%. Conclusion: The initial SPT and SPT values were significantly correlated with and can predict outcomes of EA. Key words: Egg allergy, atopic dermatitis, outcome, related factors.

show abstract

Outcomes of Baked Milk and Egg Challenge in Cow’s Milk and Hen’s Egg Allergy: Can Tolerance Be Predicted with Allergen-Specific IgE and Prick-to-Prick Test?

Cited by 23 publications

References 32 publications

Evaluation of some predictive parameters for baked milk tolerance in children with cow's milk allergy

Evaluation of some predictive parameters for baked milk tolerance in children with cow's milk allergy

Is it possible to predict the development of anaphylaxis before oral food challenge tests administered to evaluate tolerance in IgE-mediated food allergy in children?

Predictive factors of egg allergy clinical outcomes in infants and young children

Contact Info

Product

Resources

About