title: Risk of adverse IgE-mediate reaction at the first egg ingestion in children with atopic dermatitis. Results of a case-control study.
abstract: BACKGROUND
  Studies have reported that children with atopic dermatitis (AD) have a high risk of adverse reactions at first egg ingestion.
  
  
  METHODS
  We enrolled 79 children with AD retrospectively and 45 children without AD (control group) prospectively, who had never eaten egg. All children underwent skin prick tests (SPT) with commercial extracts and prick by prick with natural food (raw and boiled egg). Oral food challenge (OFC) was performed in SPT positive patients.
  
  
  RESULTS
  Sixty-six percent (52/79) of AD group and 11% (5/45) of Control group had at least one positive SPT (p<0.001), Relative Risk (RR)=5.9 and Odds Ratio=15.4. Of the 46/52 sensitised children in the AD group, 36 children ate egg for the first time in hospital during an OFC and 10 children ate egg at home because of their parents' choice, with 19/46 (41%) resulting in allergic reactions to raw and/or boiled egg. Four/five sensitised children in the control group underwent OFC and three of them (75%) showed an allergic reaction to raw, but not boiled egg. Thirty percent (14/46) of AD group had a systemic reaction vs. 25% (1/4) of Control group.
  
  
  CONCLUSIONS
  A child with AD has a RR of sensitisation to egg six times higher than a child without AD, before the first known ingestion. We propose to test sensitisation to egg in every child with AD who has never eaten egg, and to perform OFC in those with positive SPT in hospital setting.
authors.affiliation: Department of Paediatrics, Catholic University, Rome, Italy. Electronic address: smicelisopo@rm.unicatt.it.
authors.forename: S
authors.initials: S
authors.lastname: Miceli Sopo
authors.affiliation: Department of Paediatrics, Catholic University, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Monaco
authors.affiliation: Department of Paediatrics, Catholic University, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Giorgio
authors.affiliation: Department of Paediatrics, "San Camillo de Lellis" Hospital, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Calvani
authors.affiliation: Paediatric Allergology Unit, Sandro Pertini Hospital, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Tripodi
authors.affiliation: Department of Paediatrics, Catholic University, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Onesimo
mesh_terms: D016022:Case-Control Studies; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000150:complications* / Q000276:immunology; D021181:Egg Hypersensitivity / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012882:Skin Tests
chemical_list: D007073:Immunoglobulin E