Egg white specific IgE levels in serum as clinical reactivity predictors in the course of egg allergy follow-up

Montesinos E, Martorell A, Felix R, Cerda JC. Egg white specific IgE levels in serum as clinical reactivity predictors in the course of egg allergy follow-up. Pediatr Allergy Immunol 2010: 21: 634–639. © 2009 John Wiley & Sons A/S It is thought that the natural evolution of egg allergy has a good tolerance prognosis. However, there are few follow-up studies that determine the exact probability of tolerance. The aim of this study was to determine the likelihood that children younger than 2,5 years of age with allergy to egg would eventually have tolerance to it and to analyze if monitoring egg white–specific IgE level over time could be used as a predictor for determining when patients develop clinical tolerance. We performed a retrospective study of our last 42 patients diagnosed with egg allergy. Annual follow-up comprised prick testing, specific IgE (sIgE) and provocation testing with egg white (EW), allowing the prediction of tolerance at that timepoint with a probability of ≥95%. Median survival time was 48 months. The mean initial and final levels of EW sIgE were lower in the patients that reached tolerance (p 95%) at the different follow-up timepoints analyzed (25-36, 37-48 and 49-60 months. Quantification of egg whitespecific IgE levels is a useful test for diagnosing symptomatic allergy to egg white in the pediatric population and could eliminate the need to perform oral challenges tests in a significant number of children.