Developing tolerance for baked eggs may improve quality of life in kids with egg allergy

LOUISVILLE, Ky. — Children with egg allergy who practiced strict avoidance had worse quality of life than those who did tolerated baked eggs, according to study results.

“Studies report that 70% of egg-allergic patients can tolerate baked egg in their diet,” Nayna Maini, MD, third-year pediatric resident in the division of allergy, immunology and rheumatology at the Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, said during her presentation at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.

“Many patients with food allergy can live in fear and experience both social and dietary limitations due to the threat of accidental exposure to certain allergens and anxiety regarding anaphylactic reactions,” Maini said.

However, she continued, regular ingestion of baked egg may accelerate tolerance among children and help them outgrow their allergy sooner.

The study comprised 26 patients aged 17 years and younger, including 12 (83.3% aged 2-3 years; 58.3% boys; 83.3% white) who had participated in a baked egg challenge more than 6 months before enrollment in the study and 14 (57.1% aged 4-18 years; 57.1% boys; 64.3% white) who practiced complete egg avoidance.

“Those who completed a challenge were challenged to a flexible baked egg recipe of the family’s choice based on comparative skin testing of the item,” Maini said.

Options included one-egg sheet cake, which included one-fifteenth of an egg per piece, and two-egg muffins, which included one-third of an egg per piece.

The patients and their caregivers also completed an age-appropriate Food Allergy Quality of Life Questionnaire (FAQLQ) that evaluated the emotional impact of allergy, food anxiety and social and dietary limitation. Higher FAQLQ scores indicated greater negative impacts on quality of life.

Based on analysis of a two-sample t test, the researchers determined that patients who practiced strict egg avoidance had higher FAQLQ scores than the patients who had incorporated baked egg into their diet.

The mean scores for FAQLQ responses filled out by parents for children aged 0 to 12 years included 2.808 (standard deviation [SD], 1.57) for the patients who avoided egg and 1.413 (SD, 1.072) for those who tolerated baked egg.

There also was a statistically significant difference in the mean scores for FAQLQ responses completed by parents between the children who avoided egg and those who tolerated baked egg (P = .015).

“In conclusion, patients who practice strict egg avoidance demonstrated greater impairment in quality of life than those who have undergone a baked egg challenge and continue to incorporate egg into their diet,” Maini said.

By ingesting baked products, Maini suggested, children may see the resolution of their egg allergy accelerate.

“Therefore, if an egg-allergic child has not yet introduced baked egg into their diet, consider physician-supervised baked egg oral food challenge not only to help resolve their egg allergy but to improve their quality of life,” she said.