Factors predicting tolerance of egg allergy

Abstract

Background: Eggs are a common cause of food allergy in children. The natural history and risk factors for tolerance of egg allergy vary among different countries. Objective: We sought to assess the age of resolution of IgE-mediated egg allergy and to identify clinical predictors for tolerance. Methods: Children with IgE-mediated egg allergy were recruited. Clinical history, laboratory results, and the age of tolerance were evaluated. Egg tolerance was determined on the basis of the outcome of the oral food challenge. Results: Seventy-eight patients were recruited (median current age, 79 months). The median ages of egg white allergy at diagnosis and tolerance were 7 months (interquartile range, 6-9.25 months) and 56 months (interquartile range, 38-96.5 months), respectively. Sixty-one patients (78.2%) had concomitant atopic dermatitis. Egg allergy resolved in 3.8% at age 1 year, in 16.7% at age 2 years, in 50.5% by age 5 years, and in 74.6% by age 10 years. In multivariable Cox regression analysis, patients without concomitant allergic rhinitis (adjusted hazard ratio, 2.86; 95% CI, 1.62-5.04; P < .001) and egg yolk allergy (adjusted hazard ratio, 1.91; 95% CI, 1.09-3.34; P = .02) were independent predictors of egg tolerance. When using the log-rank test, both factors were significantly associated with a shorter duration of egg allergy (P < .001 and P < .027, respectively). Conclusions: The median age of egg tolerance was 56 months. The absence of allergic rhinitis and the lack of egg yolk allergy were the most consistent predictors of tolerance.