Effect of Egg White Elimination Diet on Clinical Progress and Specific IgE Levels in Egg White Sensitized Children with Atopic Dermatitis / 소아알레르기및호흡기학회지

PURPOSE: Food allergies play a major role in childhood atopic dermatitis. Egg white is the most common causative allergen in IgE mediated food allergies, and the only treatment is complete elimination of egg white from diet. The purpose of this study is to evaluate the effect of an egg white elimination diet on clinical progress and egg white-specific IgE concentration in childhood atopic dermatitis. METHOD: In 20 children with mild to severe atopic dermatitis, clinical progress was monitored by Jakob's atopic dermatitis grading system, and serum specific-IgE levels to six common food allergens and two house dust mites were measured by CAP-FEIA. RESULTS: In the study subjects, eight patients had been exposed to egg before diagnosis. During the six to 48 months of egg white elimination diet, clinical symptoms and signs were improved in 15 out of 20 patients. However, egg white-specific IgE levels were reduced by less than 1.20 kU/L (the cut off level suggesting immunological tolerance) in only seven patients. In the five patients with clinically persistent atopic dermatitis, egg white-specific IgE levels were 10.6-100 kU/L and house dust mite-specific IgE levels were 25.9-100 kU/L at the time of final examination. CONCLUSION: After 6-48 months of the egg white elimination diet, 75% of egg allergic infants and children with atopic dermatitis showed clinical improvement of atopic dermatitis. However, it is suggested that the patients need more than 1-3 years of a complete elimination diet to obtain immunological tolerance determined by egg white-specific IgE levels.

Follow-up Study of Children with Egg Allergy: Comorbidity of Allergic Diseases and Factors Affecting Prognosis / 소아알레르기및호흡기학회지

PURPOSE: Sensitization to eggs in infancy has been reported to be associated with increasing the risk of respiratory allergic diseases during childhood. So our study was designed to follow up children who have had atopic dermatitis with egg allergy and to evaluate the prognosis according to family history, early egg elimination diet, house dust mite sensitization, egg/histamine wheel ratio of skin prick test, RAST class and age tolerance to find the risk factors which might be helpful for applying some preventable measures. METHODS: Twenty three children diagnosed with egg allergy at Kangnam General Hospital between March 1988 and March 2000 were studied retrospectively. At the time of the first visit, we interviewed an feeding methods, past medical history, atopic family histories and performed skin prick tests, and total IgE and egg-white specific IgE tests (RAST). At the time of the last visit, we evaluated whether the children had allergic diseases or not, as well as prognosis and other allergen sensitization. RESULTS: Four (17.4%) children resolved allergic symptoms, Fifteen (65.2%) children had atopic dermatitis, 11 (47.8%) children had asthma, and 12 children (52.2%) had allergic rhinitis. Prognosis was good in children with early tolerance and no sensitization to house dust mites. There was no relationship between prognosis and atopic family history, early egg elimination diet, infant feeding methods, or RAST class. CONCLUSION: Because 19 (82.6%) of 23 children with egg allergy have persistent allergic diseases and related to sensitization of house dust mites, early environment intervention for house dust mites must be evaluated to prevent other allergic diseases.