Egg and cows' milk allergy in children

Area of Science:

• Pediatric Allergy and Immunology
• Clinical Nutrition
• Immunology

Background:

• Food allergies are a growing concern in pediatric populations.
• Accurate diagnosis of food allergy is crucial for effective management and prevention of atopic illness.
• Existing diagnostic criteria may not adequately capture severe reactions in highly sensitive children.

Purpose of the Study:

• To examine the relationship between a history of egg/cows' milk allergy, skin test results, and atopic illness in children.
• To evaluate the diagnostic accuracy of double-blind food challenges in suspected pediatric food allergies.
• To assess the need for modified diagnostic criteria in cases of severe food allergen reactions.

Main Methods:

• A cohort of 126 children was studied for associations between allergy history, skin prick tests, and atopic conditions.
• 40 children with suspected egg or milk allergy underwent 54 double-blind food challenges.
• Reactions were analyzed against established diagnostic criteria (Goldman's criterion).

Main Results:

• Positive skin tests were more frequent in children with a history of egg or milk allergy.
• 49% of double-blind food challenges were positive, indicating confirmed food allergy.
• Children with both a history and positive skin test were more likely to have positive challenges.
• Egg allergy suspicion led to a higher incidence of positive challenges than milk allergy suspicion.
• Many children with positive challenges did not meet the minimum of three positive challenges due to reaction severity.

Conclusions:

• A history of food allergy and positive skin tests are significant indicators of atopic illness in children.
• Double-blind food challenges are effective in diagnosing pediatric food allergies, with nearly half of suspected cases confirmed.
• Current diagnostic criteria may be too stringent for children experiencing severe reactions, necessitating a review for improved sensitivity.