title: Incidence and natural history of hen's egg allergy in the first 2 years of life-the EuroPrevall birth cohort study.
abstract: BACKGROUND
  Parents and health staff perceive hen's egg allergy (HEA) as a common food allergy in early childhood, but the true incidence is unclear because population-based studies with gold-standard diagnostic criteria are lacking.
  
  
  OBJECTIVE
  To establish the incidence and course of challenge-confirmed HEA in children, from birth until the age of 24 months, in different European regions.
  
  
  METHODS
  In the EuroPrevall birth cohort study, children with a suspected HEA and their age-matched controls were evaluated in 9 countries, using a standardized protocol including measurement of HE-specific immunoglobulin E-antibodies in serum, skin prick tests, and double-blind, placebo-controlled food challenges (DBPCFC).
  
  
  RESULTS
  Across Europe, 12 049 newborns were enrolled, and 9336 (77.5%) were followed up to 2 years of age. In 298 children, HEA was suspected and DBPCFC was offered. HEA by age two was confirmed in 86 of 172 challenged children (mean raw incidence 0.84%, 95% confidence interval (95% CI) 0.67-1.03). Adjusted mean incidence of HEA was 1.23% (95% CI 0.98-1.51) considering possible cases among eligible children who were not challenged. Centre-specific incidence ranged from United Kingdom (2.18%, 95% CI 1.27-3.47) to Greece (0.07%). Half of the HE-allergic children became tolerant to HE within 1 year after the initial diagnosis.
  
  
  CONCLUSIONS
  The largest multinational European birth cohort study on food allergy with gold-standard diagnostic methods showed that the mean adjusted incidence of HEA was considerably lower than previously documented, although differences in incidence rates among countries were noted. Half of the children with documented HEA gained tolerance within 1 year postdiagnosis.
authors.affiliation: Allergy Unit, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Xepapadaki
authors.affiliation: Division of Allergy, Pediatric Hospital Bambino Gesù, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Fiocchi
authors.affiliation: Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Grabenhenrich
authors.affiliation: Clinical and Experimental Sciences Academic Units, Faculty of Medicine, University of Southampton, Southampton, UK.
authors.forename: G
authors.initials: G
authors.lastname: Roberts
authors.affiliation: Clinical and Experimental Sciences Academic Units, Faculty of Medicine, University of Southampton, Southampton, UK.
authors.forename: K E C
authors.initials: KE
authors.lastname: Grimshaw
authors.affiliation: Department of Allergy, Hospital La Paz Institute for Health Research, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Fiandor
authors.affiliation: Department of Allergy, Hospital La Paz Institute for Health Research, Madrid, Spain.
authors.forename: J I
authors.initials: JI
authors.lastname: Larco
authors.affiliation: Department of Immunology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: S
authors.initials: S
authors.lastname: Sigurdardottir
authors.affiliation: Children's Hospital, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: M
authors.initials: M
authors.lastname: Clausen
authors.affiliation: Allergy Unit, 2nd Pediatric Clinic, University of Athens, Athens, Greece.|Centre for Paediatrics and Child Health, Institute of Human Development, University of Manchester, Manchester, UK.
authors.forename: N G
authors.initials: NG
authors.lastname: Papadopoulos
authors.affiliation: Division of Allergy, Pediatric Hospital Bambino Gesù, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Dahdah
authors.affiliation: Institute of Food Research, Norwich Research Park, Colney, Norwich, UK.
authors.forename: A
authors.initials: A
authors.lastname: Mackie
authors.affiliation: Department of Pediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: A B
authors.initials: AB
authors.lastname: Sprikkelman
authors.affiliation: Department of Pediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: A A
authors.initials: AA
authors.lastname: Schoemaker
authors.affiliation: Vilnius University Faculty of Medicine, Vilnius, Lithuania.
authors.forename: R
authors.initials: R
authors.lastname: Dubakiene
authors.affiliation: Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania.
authors.forename: I
authors.initials: I
authors.lastname: Butiene
authors.affiliation: Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Lodz, Poland.
authors.forename: M L
authors.initials: ML
authors.lastname: Kowalski
authors.affiliation: Department of Pediatrics, Immunology and Nephrology, Polish Mother's Health Centre Research Institute Łódź, Lodz, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Zeman
authors.affiliation: Neonatal Intensive Care Unit, Alexandra University Hospital, Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Gavrili
authors.affiliation: Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.|Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Keil
authors.affiliation: Department of Paediatric Pneumonology and Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Beyer
mesh_terms: D000485:Allergens / Q000276:immunology*; D000818:Animals; D002645:Chickens; D015331:Cohort Studies; D021181:Egg Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D004531:Eggs / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D015994:Incidence; D008297:Male; D011159:Population Surveillance; D012882:Skin Tests
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: children; egg allergy; epidemiology