Table of Contents
ISRN Allergy
Volume 2012, Article ID 627545, 6 pages
http://dx.doi.org/10.5402/2012/627545
Research Article

Unscrambling Egg Allergy: The Diagnostic Value of Specific IgE Concentrations and Skin Prick Tests for Ovomucoid and Egg White in the Management of Children with Hen’s Egg Allergy

1Clinical Investigation Unit, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK
2Paediatric Allergy, Immunology and Infectious Diseases, Southampton University Hospital NHS Trust, Tremona Road, Southampton SO16 6YD, UK
3Immunology Department, Southmead Hospital, Bristol BS10 5NB, UK
4School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK

Received 1 December 2011; Accepted 25 December 2011

Academic Editors: A. Horner and A. Kantar

Copyright © 2012 D. E. Marriage et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Resolution of egg allergy occurs in the majority of egg allergic children. Positive specific IgE antibodies to ovomucoid (OVM) have been suggested to be of greater predictive value for persistent egg allergy than specific IgE to egg white. The performance of OVM-specific IgE antibody levels in a cohort of children referred for a routine egg challenge was compared with egg white specific IgE levels in predicting a positive egg challenge. 24/47 subjects had persistent egg allergy. Receiver operating characteristic analysis showed that OVM-specific IgE testing was the most useful test for the diagnosis of persistent egg allergy. The optimal decision points for the prediction of persistent egg allergy were >0.35  k U A / L for specific IgE levels to both EW and OVM, and ≥3 mm for SPT. Children with specific IgE levels suggestive of persistent egg allergy need not be subject to an egg provocation challenge, reducing both costs and risks to the child.