Egg allergy in childhood: an update.
OBJECTIVE
Allergy to hen's egg is common in infancy and childhood. The management of egg allergy involves dietary avoidance of egg-containing foods, implementation of anaphylaxis precautions and ongoing monitoring for tolerance development. In this article, we review the recent literature regarding the immunology, clinical presentation, diagnosis, management and natural history of egg allergy.


RESULTS
Retrospective studies suggest that most egg-allergic children will become tolerant over time. Regular ingestion of small quantities of cooked egg in baked products is often well tolerated and may hasten tolerance development. Influenza vaccination of egg-allergic patients remains controversial, and immunization of patients with previous significant reactions or anaphylaxis to egg is currently not recommended. In recent years, there has been increasing success in clinical trials of specific oral tolerance induction to egg, but concerns regarding the safety and long-term efficacy still preclude the use of oral immunotherapy in clinical practice.


CONCLUSIONS
Egg allergy generally has a good prognosis. Despite recent advances in oral immunotherapy trials, the treatment of egg allergy currently relies on avoidance of egg-containing foods until tolerance has developed. It remains unclear whether the ongoing low-dose exposure to egg proteins in cooked foods improves the natural history of egg allergy.
Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Australia.
Dean
D
Tey
Ralf G
RG
Heine
D000485:Allergens / Q000009:adverse effects / Q000276:immunology; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D021181:Egg Hypersensitivity / Q000175:diagnosis* / Q000276:immunology* / Q000628:therapy; D004527:Egg Proteins / Q000009:adverse effects* / Q000276:immunology; D004531:Eggs / Q000009:adverse effects*; D006801:Humans; D007108:Immune Tolerance; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage; D012307:Risk Factors; D012882:Skin Tests
D000485:Allergens; D004527:Egg Proteins; D007252:Influenza Vaccines; D007073:Immunoglobulin E