Tolerance to cooked egg in infants with risk factors for egg allergy after early introduction of baked egg

Egg allergy (EA),along with cow's milk allergy (CMA) and atopic dermatitis (AD is one of the most frequent allergies in children. Tolerance to food allergens seems to be related to the early and regular intake and the cooking method. The objective of this study is to prove that the introduction of baked eggs at 4-6 months of age and its daily maintenance for 6 months prevents EA. Controlled randomized clinical trial from February 2019 to November 2023 was done for all patients under 6 months of age, including those with CMA and/or AD without previous egg consumption. Skin prick test (SPT), specific immunoglobulin E (sIgE), basophil activation test (BAT), and oral food challenge (OFC) on baked eggs were performed at the beginning of the study (T0). Patients were classified into group A (nontolerant to baked egg) following an egg-free diet and group B (tolerant to baked egg). These were randomized into B1 who ate baked egg daily and B2 who avoided egg. Six months later, at time 1 (T1), an OFC to hard-boiled egg was performed. There were 27 patients in all. Those who ate baked egg daily for 6 months tolerated boiled eggs and only 47.4% of patients who followed an egg-free diet tolerated boiled eggs (P-value 0.012). All three tests-sIgE, SPT, and BAT-are considered good techniques to discriminate between tolerant versus not tolerant patients toward eggs.Patients under 6 months of age with CMA and/or AD who ate baked eggs daily for 6 months tolerated cooked eggs more frequently than patients who avoided eggs. Early introduction of baked eggs could prevent EA.