Is oral food challenge useful to avoid complete elimination in Japanese patients diagnosed with or suspected of having IgE-dependent hen's egg allergy?

DOI Web Site 22 References
  • Murai Hiroki
    Department of Pediatrics, University of Fukui
  • Irahara Makoto
    Allergy Center, National Center for Child Health and Development
  • Sugimoto Mayumi
    Department of Pediatrics, Tokushima University Hospital
  • Takaoka Yuri
    Department of Pediatrics, Osaka Habikino Medical Center
  • Takahashi Kyohei
    Department of Pediatrics, National Hospital Organization Sagamihara National Hospital
  • Wada Takuya
    Department of Pediatrics, Faculty of Medicine, University of Toyama
  • Yamamoto-Hanada Kiwako
    Allergy Center, National Center for Child Health and Development
  • Okafuji Ikuo
    Department of Pediatrics, Kobe City Medical Center General Hospital
  • Futamura Masaki
    Department of Pediatrics, National Hospital Organization Nagoya Medical Center
  • Yamada Yoshiyuki
    Department of Allergy and Immunology, Gunma Children's Medical Center Department of Pediatrics, Tokai University School of Medicine
  • Ebisawa Motohiro
    Clinical Research Center for Allergology and Rheumatology, National Hospital Organization Sagamihara National Hospital

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Other Title
  • CQ3　日本のIgE依存性鶏卵アレルギー患者もしくはその疑いのある者において，食物経口負荷試験は完全除去回避に有用か？

Description

<p>Background: IgE-mediated egg allergy is a common food allergy worldwide. Patients with egg allergy are known to easily achieve tolerance compared to other allergens such as nuts. Oral food challenge (OFC) is often performed on patients diagnosed with or suspected of having IgE-mediated food allergy, but whether hen's egg OFC is useful in IgE-dependent egg allergy patients to avoid complete elimination remains unknown.</p><p>Methods: We identified articles in which OFCs were performed in Japanese patients diagnosed with or suspected of having IgE-mediated egg allergy. We evaluated whether the OFCs were useful to avoid the complete elimination of eggs by assessing the following: (1) the number of patients who could avoid complete elimination; (2) the number of patients who experienced serious adverse events (SAEs); or (3) adverse events (AEs); (4) improvement in quality of life (QOL); and (5) immunological changes.</p><p>Results: Fifty-nine articles were selected in the study; all the references were case series or case studies in which OFC was compared to pre-challenge conditions. The overall negative ratio against egg OFC was 62.7%, but an additional 71.9% of OFC-positive patients could take eggs when expanded to partial elimination. Of the 4,182 cases, 1,146 showed AEs in the OFC, and two cases reached an SAE. Two reports showed an improvement in QOL and immunological changes, although the evidence was weak.</p><p>Conclusions: OFCs against eggs may be useful to avoid complete elimination, but medical professionals should proceed with the test safely and carefully.</p>

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