Clinical Outcomes Of Egg Allergy In Infants And Young Children

BackgroundHen egg allergy is one of the most common food allergy in children.Deep understanding of egg allergy(EA)in infants and young children may provide better management strategies at early of life.AimTo explore the incidence,clinical characteristics and tolerance processes of EA in infants and young children and predict the clinical outcomes and probably factors which may affect the prognosis of egg allergy.Methods1.Total of 181 children aged 0-3 years with atopic dermatitis(AD)were recruited into our study from 2018 to 2019 which were confirmed as egg allergy by history,skin prick test(SPT)and food avoidance and reintroduce test.78 Patients were diagnosed as EA,among those 7 cases were only allergic to egg yolk(Only EYA),20 cases were only allergic to egg white(Only EWA),and 51 cases were allergic to whole egg(WEA).2.All the confirmed subjects were followed up for 18 months,the clinical characteristics and outcomes of these groups were respectively compared.Logistic regression analysis was used to detect the disease course and related risk factors of outcomes in children with egg allergy and with allergic to different ingredients of egg,and Receiver operating characteristic curve(ROC curve)was used to establish a predicting model.Results1.The prevalence of EA in infants and young children with AD is 43%,moderate and severe AD is closely related to EA.The clinical symptoms in the WEA group were more severe and persistent than those in Only EWA and Only EYA groups.2.43 cases of egg allergy were tolerated,average tolerated age 32.3 ±8.7 months,the tolerance rate of patients with egg yolk(EY)allergy was 75.9% and egg white(EW)was 56.3%.The SPT wheal diameter at initial diagnosis(SPTdiag)was the risk factor for persisting egg allergy(OR=1.209,95%CI:1.041-1.403;OR=1.304,95%CI:1.132-1.500),when EY-SPTdiag>7.75mm、EW-SPTdiag>10.25 mm,it is not easy to obtain egg allergy tolerance.The reduction rate of SPT wheal diameter after 6months from diagnosis(△ SPT6mo)in the tolerant group decreased markedly compared to the persistent group.When △ EW-SPT6 mo was ≥ 39.5% 、 △EY-SPT6 mo was≥27%,tolerance acquisition was more frequent.3.The EA group had a higher occurrence of respiratory symptoms than the control group(61.5% VS 48.7%).Persisting egg allergy is related to rhinitis symptoms and asthma.Conclusion1.The moderate and severe AD was strongly associated with EA.Children with egg white allergy,compared to those who allergic to egg yolk,have more clinical effects and slower tolerance rates.2.Initial size of SPTdiag and changing of SPT during 6months were significantly correlated with outcomes of egg allergy.3.Persisting egg allergy was risk factor of rhinitis and asthma in later of childhood.