Allergy to egg whites: diagnosis, symptoms (clinical features), prognosis

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Allergic reactions to hen’s egg are rather a common problem, especially in infants. Hen’s eggs contain a few protein components which may serve as food allergens. They are 4 egg-white proteins: ovomucoid (Gal d 1, 11%), ovalbumin (Gal d 2, 54%), ovotransferrin (Gal d 3, 12%), lysozyme (Gal d 4, 3,4%) and one egg-yolk protein - alpha-livetin (Gal d 5). Ovomucoid (OVM) is the dominant allergen in hen’s egg. The allergenicity of egg whites depends mostly on their resistance to heat and digestive enzymes. A skin prick test size of 5 mm in children younger than 2 years old and 7 mm in children older than 2 years had a positive predicative value (PPV) of 100%. However, patient questioning and skin testing cannot be the only proof of food allergy. There exists a positive correlation between the growing levels of eggs-pecific IgE and the probability of allergic symptoms occurrence. Testing for sensitization to different hen’s egg proteins (molecular diagnostic) may assist in marking off allergy reaction to raw eggs from that one to heat-treated eggs. Questionable cases call for carrying out challenge tests which are not certified in Russia. The recent studies have demonstrated the safety of measles vaccination in children with proven eggwhite allergy. Currently, oral, sublingual and epicutaneous immunotherapy for food allergy to egg-whites has been extensively investigated in clinical trials.

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A V Kudryavtseva

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)


Y A Boguslavskaya

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)


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