Baked Egg: Improving characterization and management of egg allergic patients

Andrea and Sylvia, 3-year-old girls both with a history of eczema and positive skin-prick test for egg white, are seen by their healthcare provider for additional insight into their egg allergies.

Andrea and Sylvia’s healthcare provider conducts a full clinical history and physical examination and decides to test using egg components.

Andrea and Sylvia were both diagnosed with egg allergies as infants. Will their test results change over time?

Patient History

Family History

None

Andrea and Sylvia Have the Same Personal History

Severe eczema since 6 to 7 months of age.
Gastrointestinal symptoms.
Urticaria and wheezing when accidentally eating egg.

Skin Prick Test
Test	Type	Andrea's Results	Sylvia's Results
Egg White	Whole Alergen	+5	+4

Andrea and Sylvia had a negative skin-prick test to milk.

ImmunoCAP™ Test Results (KU_A/I)
Test	Type	Andrea's Results	Sylvia's Results
Egg white	Whole Allergen	20	22

Based on history, evaluation, and testing their previous healthcare provider recommended that Andrea and Sylvia remove egg entirely from their diets.

ImmunoCAP Test Results

These results, together with Andrea and Sylvia's case history and symptoms, may help their healthcare provider confirm the diagnosis.

ImmunoCAP Test Results (KU_A/I)
Test	Type	Andrea's Results	Sylvia's Results
Egg white	Whole Allergen	16	19
Gal d 1 (Ovomucoid)	Allergen Component	0.4	16
Gal d 2 (Ovabumin)	Allergen Component	11.1	6.9
Gal d 3 (Conalbumin)	Allergen Component	0.4	0.2
Gal d 4 (Lysozyme)	Allergen Component	4.5	0.3

Differential Diagnosis

Andrea

Andrea’s low level of sensitization to Gal d 1 may be an indication of tolerance to baked egg.^1,2 An open challenge in the clinic with baked egg may be performed to help you confirm the diagnosis. With components, Andrea’s quality of life could have been improved: No need of strict avoidance of egg and no cause of stress in the family due to the risk of eating products containing baked egg, such as cakes and cookies.

REFINED DIAGNOSIS

Likely tolerant to baked egg.

HEALTHCARE PROVIDER MANAGEMENT PLAN

Andrea’s healthcare provider advised that she undergo an oral food challenge with a specialist to confirm tolerance to baked egg.

FOLLOW UP

Andrea has successfully passed the oral food challenge for baked egg and has been eating foods containing extensively baked egg since with no issues.

Sylvia

Sylvia’s significant levels of specific IgE to Gal d 1 indicates that she has a risk for reaction to all forms of egg.^1,2

REFINED DIAGNOSIS

Egg allergy.

HEALTHCARE PROVIDER MANAGEMENT PLAN

Sylvia’s healthcare provider advised a dietary restriction to all forms of egg remains.

FOLLOW UP

Sylvia is seen by her healthcare provider one year later. She has continued to avoid egg in all forms and is doing well. Her autoinjector technique is satisfactory.

It may be wise to re-test her to see if she may have outgrown her egg allergy and ready to go through an oral challenge.

The people, places, and events depicted in these case studies and photographs do not represent actual patients, nor are they affiliated in any way with Thermo Fisher Scientific.