egg-white and Urticaria

Topics: Acute Disease; Child, Preschool; Cooking; Dermatitis, Atopic; Desensitization, Immunologic; Earache; Egg White; Egg Yolk; Eggs; Food Hypersensitivity; Humans; Immunoglobulin E; Male; Otitis Media; Recurrence; Skin Tests; Urticaria

We occasionally see egg-allergic children who develop contact urticaria to hen's egg despite the absence of the overt symptoms on ingestion. The mechanisms remain to be elucidated.. Twenty-one subjects with positive reactions to 20-min patch tests for egg-white antigens were divided into subgroups with positive (n = 10) and negative (n = 11) results to oral challenge tests by the same antigens. We measured IgE antibody for egg white and its components, and IgE-binding activities to digestive enzyme-treated ovomucoid by RAST inhibition.. There were no significant differences in IgE antibody titers to egg white (positive vs negative: 30.3% vs 15.3%, P=0.130), ovomucoid (21.5% vs 10.2%, P= 0.078), ovotransferrin (9.9% vs 3.7%, P = 0.105), and lysozyme (3.4% vs 2.9%, P=0.944), except ovalbumin (16.8% vs 5.6%, P=0.024), between the positive and negative subjects in the provocation tests. In contrast, the concentration (1.93 microg/ml) of pepsin-treated ovomucoid needed for 50% RAST inhibition in the challenge-positive subjects was significantly (P=0.0003) lower than that (114.9 microg/ml) of negative subjects. Similar but less significant differences were obtained when ovomucoid fragments treated with chymotrypsin (0.91 microg/ml vs 6.86 microg/ml, P=0.014) and trypsin (0.75 microg/ml vs 4.67 microg/ml, P= 0.041) were used as inhibitors.. We suggest that IgE antibodies from subjects showing contact urticaria despite the absence of reactions to the ingestion of egg white recognize the epitope(s) unstable to digestive enzymes.

Topics: Administration, Oral; Allergens; Animals; Child; Child, Preschool; Chymotrypsin; Conalbumin; Double-Blind Method; Egg White; Eggs; Female; Food Hypersensitivity; Humans; Immunoglobulin E; Infant; Male; Muramidase; Ovalbumin; Ovomucin; Pepsin A; Placebos; Radioallergosorbent Test; Trypsin; Urticaria

The current increase in the prevalence of food allergies appears to have several causes including better screening, improved diagnosis and changes in both the techniques used by food manufacturers and eating habits. Labial food challenge (LFC)is simple, rapid to perform and is associated with only low risks of systemic reaction. It is thus an appealing alternative to the oral food challenge (OFC) for pediatric use. We report a series of 202 LFC performed over two years in 142 children with food allergy suspected from the case history, positive skin prick tests and specific serum IgE assays: 156 LFC were positive; and 46 negative, followed by positive single-blind, placebo-controlled food challenges (SBPCFC). The foods provoking reactions were egg white (75 cases), peanut (60 cases), mustard (23 cases), cow's milk (13 cases), cod (8 cases), kiwi fruit, shrimp (4 cases each), chicken, peanut oil (3 cases each), hazel nuts (2 cases), and snails, apple, fennel, garlic, chilli peppers, pepper, and duck (1 case each). LFC positivity was mostly (89.7% of cases) manifested as a labial edema with contiguous urticaria. There were systemic reactions in 4.5% of cases: generalized urticaria, hoarseness and rapid-onset and generalized eczema. The 46 infants with negative LFC results had positive SBPCFC. The reactions were in 34 cases generalized urticaria, 10 cases asthma attacks, 2 cases early and generalized eczema, and in one case general anaphylactic shock. The sensitivity of the LFC was 77%. The LFC was easy to perform with children. Positive results indicate the presence of food allergy, but negative results require further investigations preferably double-blind, placebo-controlled food challenge (DBPCFC).

Topics: Administration, Oral; Adolescent; Anaphylaxis; Animals; Arachis; Asthma; Child; Child, Preschool; Dermatitis, Atopic; Egg White; Female; Fishes; Food; Food Hypersensitivity; Humans; Immunoglobulin E; Labial Frenum; Male; Milk; Mustard Plant; Plants, Medicinal; Skin Tests; Urticaria

Celiac disease, eosinophilic esophagitis, and urticaria are 3 manifestations of food allergy with different pathogenic mechanisms. We report the case of a 2-year-old child with digestive symptoms, slow growth, and severe asthma. The results of skin prick tests were positive to several foods. Endoscopy revealed eosinophilic esophagitis and celiac disease. Treatment consisted of a gluten-free diet and a 1-month course of oral corticosteroids. Endoscopy and biopsy findings were normal at 5 years of age. A gluten-free diet is the basis of treatment of celiac disease, but the role of an elimination diet in eosinophilic esophagitis is not well established. Our patient also developed urticaria when exposed to milk and egg.We present, to our knowledge, the first report of a patient with celiac disease, eosinophilic esophagitis, and immediate-type immunoglobulin E-mediated food allergy.

Topics: Animals; Celiac Disease; Child, Preschool; Diet, Gluten-Free; Egg White; Eosinophilic Esophagitis; Female; Food Hypersensitivity; Glutens; Humans; Immunoglobulin E; Milk; Treatment Outcome; Urticaria

Topics: Allergens; Double-Blind Method; Egg Hypersensitivity; Egg White; Egg Yolk; False Positive Reactions; Humans; Immunoglobulin E; Infant; Male; Placebos; Urticaria

In 80 preterms aged 9-24 months (mean age: 15.9) and in 80 sex- and age-matched full-terms the frequency of atopic diseases and of positive skin tests to 8 food and 6 inhalant allergens was determined. The two groups did not differ as to overall percentages of cutipositive subjects and patients with atopic diseases. In particular, frequencies of positive skin tests to foods and of atopic dermatitis (the peak prevalence of which occurs early in infancy) were similar in preterm (16.2 and 7.5%, respectively) and full-term (13.7 and 5.0%, respectively) infants. We suggest that preterm infants fed human milk are not at increased risk of developing food allergy and related diseases and that the absorption of antigens through the immature intestine does not seem to favor the development of an IgE sensitization to foods.

Topics: Animals; Arthrodermataceae; Dermatitis, Atopic; Egg White; Female; Food Hypersensitivity; Humans; Infant; Infant, Newborn; Infant, Premature; Male; Milk; Milk, Human; Respiratory Sounds; Skin Tests; Urticaria

Topics: Diaper Rash; Egg White; Humans; Infant; Male; Urticaria

Various clinical features of eighty-four atopic patients, with clinical hypersensitivity to egg and positive RAST to egg white, were studied. Some of the clinical data were compared with data from a control group of atopic patients without egg allergy. Atopic diseases and certain food allergies in the families of the egg-allergic patients and atopic controls were also studied. This was done in order to investigate the extent to which differences between the egg allergy group and the atopic control group were reflected in their respective families.

Topics: Adolescent; Animals; Asthma; Breast Feeding; Cattle; Child; Child, Preschool; Dermatitis, Atopic; Egg White; Fish Products; Food Hypersensitivity; Humans; Hypersensitivity, Immediate; Immunoglobulin E; Infant; Milk; Radioallergosorbent Test; Skin Tests; Urticaria

Topics: Allergens; Animals; Antibodies; Asthma; Cats; Child; Child, Preschool; Dogs; Dust; Eczema; Egg White; Female; Fishes; Follow-Up Studies; Horses; Humans; Immunoglobulin E; Infant; Male; Milk; Pollen; Radioimmunoassay; Rhinitis, Allergic, Seasonal; Skin Tests; Urticaria

Topics: Animals; Egg White; Guinea Pigs; Hypersensitivity; Immune System Diseases; Urticaria