Is it possible to make a diagnosis of raw, heated, and baked egg allergy in children using cutoffs? A systematic review

Pediatric Allergy and Immunology - Tập 26 Số 6 - Trang 509-521 - 2015
Mauro Calvani1, Stefania Arasi2, Annamaria Bianchi3, Davide Caimmi4, Barbara Cuomo5, Arianna Dondi6, Giovanni Cosimo Indirli7, Stefania La Grutta8, Valentina Panetta9, Maria Carmen Verga10
1Operative Complex Unit of Pediatrics S. Camillo‐Forlanini Hospital Rome Italy
2Department of Pediatrics, University of Messina, Messina, Italy
3Operative Complex Unit of Pediatrics and Neonatal Patology, Mazzoni Hospital, Ascoli Piceno, Italy
4Pediatric Respiratory Diseases Unit of the Department of Pediatrics Allergy Unit of the Department of Respiratory Diseases University Hospital of Montpellier Montpellier France
5Operative Complex Unit of Pediatrics, Hospital of Belcolle Viterbo, Belcolle Viterbo, Italy
6Pediatric Unit, Ramazzini Hospital, Carpi, Italy
7Operative Unit of Pediatric Allergy San Giuseppe da Copertino Hospital Copertino Italy
8Institute of Biomedicine and Molecular Immunology, National Research Council, Palermo, Italy
9L'altrastatistica srl, Consultancy & Training Biostatistics office Rome Italy
10Primary Care Pediatrics, ASL Salerno, Vietri sul Mare, Italy

Tóm tắt

AbstractThe 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 children <2 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 are >5 and >11 mm in children <2 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.

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Pediatric Allergy and Immunology

Tập 26 Số 6

509-521

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