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Reduction Rate of Specific IgE Level as a Predictor of Persistent Egg Allergy in Children

 Jong Deok Kim  ;  Soo Yeon Kim  ;  Eun Ji Kwak  ;  In Suk Sol  ;  Min Jung Kim  ;  Yoon Hee Kim  ;  Kyung Won Kim  ;  Myung Hyun Sohn 
 Allergy Asthma & Immunology Research, Vol.11(4) : 498-507, 2019 
Journal Title
Issue Date
Egg hypersensitivity ; child ; egg white ; food allergy ; immunoglobulin E
PURPOSE: Egg is the most common food allergen in infants. However, the natural course of egg allergy has not been fully elucidated. This study aimed to describe clinical characteristics and to identify prognostic factors associated with tolerance acquisition of immunoglobulin E (IgE)-mediated egg allergy in children.

METHODS: Children who underwent more than 1 follow-up egg white-specific immunoglobulin E (EWsIgE) test between November 2005 and November 2015 at -Severance Children's Hospital were assessed. Children were diagnosed as having IgE-mediated egg allergy based on immediate allergic reaction after egg consumption and an EWsIgE level of > 0.35 kU/L. The children were divided into "tolerant" and "persistent" groups according to tolerance acquisition defined as egg consumption without adverse allergic reactions.

RESULTS: Of 124 participants, egg allergy resolved in 101 (81.5%) children. The persistent group had more atopic dermatitis (P = 0.039), and more wheat (P = 0.009) and peanut (P = 0.012) allergies compared to the tolerant group. The EWsIgE levels at diagnosis (EWsIgEdiag) were higher in the persistent group than in the tolerant group (P = 0.001). The trend of the EWsIgE levels in the tolerant group decreased markedly over time compared to the persistent group (P < 0.001). In predicting egg allergy tolerance acquisition, the reduction rate of EWsIgE level after 12 months from diagnosis (ΔEWsIgE12mo) tended to be more accurate than EWsIgEdiag (area under the curve: 0.835 vs. 0.731). When ΔEWsIgE12mo was ≥ 30%, tolerance acquisition was more frequent than that of < 30% (91.9% vs. 57.9%; P < 0.001).

CONCLUSIONS: ΔEWsIgE12mo can be used as an early independent predictor of tolerance acquisition of IgE-mediated egg allergy in children.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0002-5634-9709
Kim, Soo Yeon(김수연) ORCID logo https://orcid.org/0000-0003-4965-6193
Kim, Yoon Hee(김윤희) ORCID logo https://orcid.org/0000-0002-2149-8501
Kim, Jong Deok(김종덕)
Sol, In Suk(설인숙) ORCID logo https://orcid.org/0000-0003-2470-9682
Sohn, Myung Hyun(손명현) ORCID logo https://orcid.org/0000-0002-2478-487X
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