title: Tolerance of a high-protein baked-egg product in egg-allergic children.
abstract: Egg allergy is one of the most common immunoglobulin E (IgE)-mediated food allergies. Extensively heating egg has been found to decrease its allergenicity and 64% to 84% of children allergic to egg have been found to tolerate baked-egg products. Because there is no reliable method for predicting baked-egg tolerance, oral food challenges remain the gold standard. Prior studies have reported on baked-egg challenges using up to 2.2 g of egg white (EW) protein.
  
  
  
  To establish whether children with egg allergy would pass a baked-egg challenge to a larger amount of egg protein and the potential criteria for predicting the likelihood of baked-egg tolerance.
  
  
  
  A chart review was conducted of all patients 6 months to 18 years of age with egg allergy who underwent oral baked-egg challenges at Children's Medical Center Dallas over a 2-year period. Challenges were conducted in the clinic with a 3.8-g baked-egg product.
  
  
  
  Fifty-nine of 94 patients (63%) tolerated the 3.8-g baked-egg product. The presence of asthma (P < .01), EW skin prick test (SPT; P < .01) reactive wheal, and EW-specific IgE level (P = .02) correlated with baked-egg reactivity, whereas ovomucoid-specific IgE level did not. The positive predictive value approached 66% at an EW SPT reactive wheal of 10 mm and 60% for an EW-specific IgE level of 8 kUA/L.
  
  
  
  Most subjects with egg allergy tolerated baked egg. This study is the first to use 3.8 g of EW protein for the challenges. The EW SPT wheal diameter and EW-specific IgE levels were the best predictors of baked-egg tolerance.
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: maryam.saifi@gmail.com.
authors.forename: Maryam
authors.initials: M
authors.lastname: Saifi
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Nithya
authors.initials: N
authors.lastname: Swamy
authors.affiliation: Children's Medical Center Dallas, Dallas, Texas.
authors.forename: Maria
authors.initials: M
authors.lastname: Crain
authors.affiliation: Parkland Health and Hospital System, Dallas, Texas.
authors.forename: L Steven
authors.initials: LS
authors.lastname: Brown
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: John Andrew
authors.initials: JA
authors.lastname: Bird
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000276:immunology*; D001249:Asthma / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003296:Cooking; D021181:Egg Hypersensitivity / Q000276:immunology*; D004527:Egg Proteins / Q000276:immunology*; D004531:Eggs; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D007073:Immunoglobulin E / Q000276:immunology; D007223:Infant; D008297:Male; D012882:Skin Tests
chemical_list: D000485:Allergens; D004527:Egg Proteins; D007073:Immunoglobulin E