1. Is it possible to make a diagnosis of raw, heated and baked egg allergy in children using cut-offs? A systematic review
- Author
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Davide Caimmi, Stefania La Grutta, Stefania Arasi, Annamaria Bianchi, Mauro Calvani, Barbara Cuomo, Giovanni Cosimo Indirli, Arianna Dondi, Maria Carmen Verga, Valentina Panetta, Calvani, M., Arasi, S., Bianchi, A., Caimmi, D., Cuomo, B., Dondi, A., Indirli, G., La Grutta, S., Panetta, V., and Verga, M.
- Subjects
cut-off ,medicine.medical_specialty ,Allergy ,Adolescent ,Immunology ,specific IgE ,Egg protein ,Egg Proteins, Dietary ,medicine.disease_cause ,Allergen ,Egg White ,oral food challenge ,Predictive Value of Tests ,Raw Foods ,Immunology and Allergy ,Medicine ,Humans ,Serologic Tests ,Cooking ,Child ,Egg Hypersensitivity ,business.industry ,Oral food challenge ,Age Factors ,Infant ,Gold standard (test) ,Immunoglobulin E ,Intradermal Tests ,medicine.disease ,Dermatology ,skin prick test ,Predictive value of tests ,Egg allergy ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,egg ,business ,Biomarkers ,Egg white - Abstract
The diagnosis of IgE-mediated egg allergy lies both on a compatible clinical history and on the results of skin prick tests (SPTs) and IgEs levels. Both tests have good sensitivity but low specificity. For this reason, oral food challenge (OFC) is the ultimate gold standard for the diagnosis. The aim of this study was to systematically review the literature in order to identify, analyze, and synthesize the predictive value of SPT and specific IgEs both to egg white and to main egg allergens and to review the cutoffs suggested in the literature. A total of 37 articles were included in this systematic review. Studies were grouped according to the degree of cooking of the egg used for OFC, age, and type of allergen used to perform the allergy workup. In children2 years, raw egg allergy seems very likely when SPTs with egg white extract are ≥4 mm or specific IgEs are ≥1.7 kUA /l. In children ≥2 years, OFC could be avoided when SPTs with egg white extract are ≥10 mm or prick by prick with egg white is ≥14 mm or specific IgE is ≥7.3 kUA /l. Likewise, heated egg allergy can be diagnosed if SPTs with egg white extract are5 and11 mm in children2 and ≥2 years, respectively. Further and better-designed studies are needed to determine the remaining diagnostic cutoff of specific IgE and SPT for heated and baked egg allergy.
- Published
- 2015