Presentation on theme: "Egg Allergy Important food allergy in children Starts early in life"— Presentation transcript:
1 Egg Allergy Important food allergy in children Starts early in life Often resolved by school ageSymptoms:atopic dermatitis, urticaria, asthma, anaphylaxisSensitization may predict atopic disease later in lifePrevalence: 1-2%Boiled/heated egg may be tolerated
2 Doctor's challenges Is there a risk for severe reactions? Could the patient tolerate cooked egg?Is the allergy likely to be persistent?How should the patient best be managed?Who needs strict avoidance?Who needs emergency medication?
3 Common clinical practice PatientPreviousAt 7 monthsAnamnesisAt 2 yearsSPT to eggDiagnosisAdviceAt 5 yearssIgE to eggFood challengeElin, 5 yearsEczemaUrticaria, asthma+5Egg allergyAvoid egg25 kUA/lNo symptomsTolerant to eggNour, 5 yearsEczemaUrticaria, asthma+4Egg allergyAvoid egg20 kUA/lUrticaria, cough, rhinitis
6 Main egg allergen components Gal d 2Ovomucoid – Gal d 1Ovalbumin – Gal d 2Ovotransferrin – Gal d 3Lysozyme – Gal d 4Gal d 3Gal d 1Gal d 4Latin name: Gal d – Gallus domesticus
7 Ovomucoid - Gal d 1 The dominant egg white component 11 % of egg white contentHighly allergenicStable to heat andenzymatic digestionGal d 1
8 Ovomucoid and tolerance Boiled egg may be tolerated if Ovomucoid-IgE levels are lowPersistent egg allergy is seen in patients with high Ovomucoid-IgE levelsThe stability of Ovomucoid reflects the clinical picture
10 Using components in clinical practice PatientPreviousAt 7 monthsAnamnesisAt 2 yearsSPT to eggsIgE to eggsIgE to OvomucoidDiagnosisAdviceElin, 5 yearsEczemaUrticaria, asthma+525 kUA/l0.4 kUA/lTolerance likelyLow risk for reactionsTry cooked eggNour, 5 yearsEczemaUrticaria, asthma+420 kUA/l12 kUA/lEgg allergyAvoid eggImproved diagnoses and altered advice
11 What does Molecular Allergology add? Sensitization to Ovomucoid indicates:Risk for reaction to all forms of eggPersistent egg allergyRisk for systemic reactions to eggAbsence of sensitization to Ovomucoid indicates:Tolerance to cooked egg
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