AUTHOR=Miyagi Yoshitsune , Yamamoto-Hanada Kiwako , Ogita Hiroya , Kiguchi Tomoyuki , Inuzuka Yusuke , Toyokuni Kenji , Nishimura Koji , Irahara Makoto , Ishikawa Fumi , Sato Miori , Saito-Abe Mayako , Miyaji Yumiko , Kabashima Shigenori , Fukuie Tatsuki , Nomura Ichiro , Ohya Yukihiro 

TITLE=Avoidance of Hen's Egg Based on IgE Levels Should Be Avoided for Children With Hen's Egg Allergy

JOURNAL=Frontiers in Pediatrics

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.583224

DOI=10.3389/fped.2020.583224

ISSN=2296-2360

ABSTRACT=<p><bold>Background:</bold> Although hen's egg (HE) allergy was thought to be usually resolved by late childhood, majority of HE allergy patients with a high level of egg white (HEW)-specific IgE could not acquire tolerance for HE by age 8 years.</p><p><bold>Objective:</bold> The aim is to investigate whether the avoidance of HE until 6 years of age increased the risk of heated HE allergy at age 6 years.</p><p><bold>Methods:</bold> This was a retrospective case-control study. The HE tolerance children (<italic>n</italic> = 17) and children with low-dose HE reactor [a positive reaction to ≤ 4 g of heated HEW in oral food challenges (OFCs)] children (<italic>n</italic> = 26) were included based on the results of OFC at 6 years old. Multivariate logistic regression analysis was applied to examine the associations between HE avoidance until age 6 years and HE allergy status confirmed by OFC, adjusting the level of ovomucoid-specific IgE (OM-sIgE) during early infancy.</p><p><bold>Results:</bold> A lower proportion of strict avoidance of HE was observed in the HE tolerance group than in the low-dose HE reactor group (6 vs. 46%, <italic>p</italic> = 0.006). OM-sIgE levels in children younger than 2 years old were significantly higher in the low-dose HE reactor group than those in the HE tolerance group (median [interquartile], 26.7 UA/mL [11.9–53.4] vs. 7.9 UA/mL [0.35–23.4]; <italic>p</italic> =0.024). The avoidance of HE until 6 years of age increased the risk of heated HE allergy even after adjusting OM-sIgE levels.</p><p><bold>Conclusions:</bold> The long-term avoidance of HE from infancy increased the risk of heated HE allergy confirmed by OFC at age 6 years.</p>