Oral and nasal provocation test in chicken egg allergy-case report

Area of Science:

• Allergology
• Immunology
• Otorhinolaryngology

Background:

• Chicken egg protein allergy is a prevalent food allergy.
• Clinical manifestations commonly involve gastrointestinal, skin, and respiratory systems.
• Accurate diagnosis relies on differential diagnosis and provocative testing.

Purpose of the Study:

• To evaluate the utility of nasal provocation testing in diagnosing chicken egg allergy.
• To assess nasal mucosa response and exhaled nitric oxide levels during allergen challenge.

Main Methods:

• A 21-year-old patient with diagnosed egg allergy underwent double-blind placebo-controlled food and nasal provocation tests.
• Nasal mucosa response was measured using visual analogue scale (VAS), acoustic/optical rhinometry, and exhaled nitric oxide (NO).
• Changes in nasal passage dimensions and subjective symptoms were recorded.

Main Results:

• Nasal provocation with 20 µg of chicken egg protein increased nasal mucosa reactivity.
• Exhaled NO levels decreased from 920 ppb to 867 ppb during the early allergic reaction.
• Significant increases in subjective symptoms (nasal obstruction, discharge, itching) were observed in the nasal test compared to the food test.

Conclusions:

• The nasal mucosa is a suitable site for evaluating allergic reactions to common food allergens like chicken egg.
• Nasal provocation tests offer a convenient method for assessing the severity of food allergies.