title: The Clinical Usefulness of IgE Antibodies Against Egg White and Its Components in Korean Children.
abstract: OBJECTIVE
  Egg (egg white) allergies are among the most common food allergies in infants and young children. Serum egg white-specific IgE (sIgE) levels have been shown to be correlated with clinical symptoms, and the predictive decision point of sIgE levels has been proposed and used widely in the clinical setting. However, some patients whose sIgE levels to egg white are higher than the predictive decision point value show no clinical symptoms, and vice versa. This study was conducted to evaluate the clinical usefulness of sIgE antibodies to egg white and its components in the diagnosis of egg allergies.
  
  
  METHODS
  Forty-one patients younger than 2 years of age with no experience of egg intake due to concerns regarding allergies or a non-specific clinical response to eggs were enrolled. Total IgE levels and the levels of IgE antibodies specific for egg white and its components (ovomucoid, ovalbumin, and conalbumin) were measured by ImmunoCAP testing. The clinical response of the subjects was confirmed by an open oral food challenge (OFC).
  
  
  RESULTS
  Fifteen (71.4%) out of 21 patients in the egg white-sIgE ≥2 kU/L group showed a positive response, while 10 (50.0%) out of 20 patients in the egg white-sIgE <2 kU/L group showed a negative response to the OFC. There were no statistically significant differences in the levels of sIgE antibodies against egg white and its components between the positive and negative open OFC groups. In addition, there were no statistically significant differences in the levels of sIgE antibodies against egg white and its components based on an intra-group analysis.
  
  
  CONCLUSIONS
  Our results show that the sensitivity and specificity of the predictive decision point values for egg white-sIgE antibodies by ImmunoCAP were relatively low in Korean children. In addition, no egg white component predicted the clinical reactivity of the subjects. We suggest that the predictive decision point value for a positive egg oral challenge test by ImmunoCAP should be re-evaluated. Moreover, we suggest that careful personal history recording and challenge tests are necessary for the correct diagnosis of an egg allergy.
authors: Pediatric Allergy and Respiratory Center, Department of Pediatrics, Soonchunhyang University Hospital, Seoul, Korea.
authors: Taek Ki
authors: TK
authors: Min
authors: You Hoon
authors: YH
authors: Jeon
authors: Hyeon Jong
authors: HJ
authors: Yang
authors: Bok Yang
authors: BY
authors: Pyun
keywords: Egg hypersensitivity; egg white proteins
references: Allergy. 2005;60 Suppl 79:19-24
references: 15842229
references: J Agric Food Chem. 1983 Sep-Oct;31(5):942-6
references: 6415139
references: J Allergy Clin Immunol. 2004 Aug;114(2):387-91
references: 15316521
references: Clin Exp Allergy. 2005 Mar;35(3):268-73
references: 15784102
references: J Allergy Clin Immunol. 2003 Jul;112(1):196-201
references: 12847499
references: J Allergy Clin Immunol. 1997 Oct;100(4):444-51
references: 9338535
references: J Allergy Clin Immunol. 2008 Sep;122(3):583-8
references: 18692888
references: J Allergy Clin Immunol. 2007 Dec;120(6):1413-7
references: 18073126
references: J Allergy Clin Immunol. 2006 Feb;117(2 Suppl Mini-Primer):S470-5
references: 16455349
references: J Allergy Clin Immunol. 2007 Sep;120(3):638-46
references: 17628647
references: J Allergy Clin Immunol. 2002 Aug;110(2):304-9
references: 12170273
references: J Immunol. 1997 Aug 15;159(4):2026-32
references: 9257870
references: Clin Exp Allergy. 1999 Jul;29(7):896-904
references: 10383589
references: N Engl J Med. 1992 Aug 6;327(6):380-4
references: 1294076
references: Allergy. 2001 May;56(5):403-11
references: 11350303
references: Pediatr Allergy Immunol. 2008 Mar;19(2):173-9
references: 18257905
references: Biosci Biotechnol Biochem. 2006 Mar;70(3):591-7
references: 16556973
references: J Allergy Clin Immunol. 2007 May;119(5):1272-4
references: 17337292
references: Clin Exp Allergy. 2001 Sep;31(9):1464-9
references: 11591198
references: J Allergy Clin Immunol. 2004 Jul;114(1):144-9
references: 15241358
references: Arerugi. 1991 Sep;40(9):1167-75
references: 1720303
references: Allergy. 2007 Jul;62(7):758-65
references: 17573723
references: J Allergy Clin Immunol. 2009 Jun;123(6 Suppl):S365-83
references: 19500710
references: J Allergy Clin Immunol. 2001 May;107(5):891-6
references: 11344358
references: J Allergy Clin Immunol. 1997 Aug;100(2):171-6
references: 9275136
references: Pediatr Clin North Am. 2011 Apr;58(2):427-43, xi
references: 21453811
references: J Allergy Clin Immunol. 1994 Jun;93(6):1047-59
references: 8006309
references: Curr Allergy Asthma Rep. 2006 Mar;6(2):145-52
references: 16566865
references: J Allergy Clin Immunol. 2004 May;113(5):805-19; quiz 820
references: 15131561