title: Allergic reactions to propofol in egg-allergic children.
abstract: BACKGROUND
  Egg and/or soy allergy are often cited as contraindications to propofol administration. Our aim was to determine whether children with an immunoglobulin (Ig)E-mediated egg and/or soy allergy had an allergic reaction after propofol use.
  
  
  METHODS
  We performed a retrospective case review over an 11-year period (1999-2010) of children with IgE-mediated egg and/or soy allergy who had propofol administered to them at the Children's Hospital Westmead, Sydney.
  
  
  RESULTS
  Twenty-eight egg-allergic patients with 43 propofol administrations were identified. No child with a soy allergy who had propofol was identified. Twenty-one children (75%) were male, the median age at anesthesia was 2.4 years (range, 1-15 years), and the presence of other atopic disease was common (eczema 61%, asthma 32%, peanut allergy 43%). Most children (n = 19, 68%) had a history of an IgE-mediated clinical reaction to egg with evidence of a significantly positive egg white skin prick test (SPT) reaction (≥7 mm). Two of these had a history of egg anaphylaxis. The remaining children (n = 9, 32%) had never ingested egg because of significantly positive SPT (≥7 mm). All SPTs to egg were performed within 12 months of propofol administration. There was one nonanaphylactic immediate allergic reaction (n = 1 of 43, 2%) that occurred 15 minutes after propofol administration in a 7-year-old boy with a history of egg anaphylaxis and multiple other IgE-mediated food allergies (cow's milk, nut, and sesame). SPT to propofol was positive at 3 mm. No other egg-allergic child reacted to propofol.
  
  
  CONCLUSIONS
  Despite current Australian labeling warnings, propofol was frequently administered to egg-allergic children. Propofol is likely to be safe in the majority of egg-allergic children who do not have a history of egg anaphylaxis.
authors.affiliation: Department of Immunology and Allergy, Children's Hospital at Westmead, Locked Bag 4001, Westmead, 2145, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Murphy
authors.forename: Dianne E
authors.initials: DE
authors.lastname: Campbell
authors.forename: David
authors.initials: D
authors.lastname: Baines
authors.forename: Sam
authors.initials: S
authors.lastname: Mehr
mesh_terms: D000293:Adolescent; D000707:Anaphylaxis / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000097:blood* / Q000175:diagnosis / Q000517:prevention & control; D021181:Egg Hypersensitivity / Q000097:blood* / Q000175:diagnosis / Q000517:prevention & control; D004529:Egg White; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007223:Infant; D008297:Male; D015742:Propofol / Q000009:adverse effects*; D012189:Retrospective Studies; D012882:Skin Tests / Q000379:methods
chemical_list: D007073:Immunoglobulin E; D015742:Propofol