Allergy Asthma Respir Dis.  2015 Jan;3(1):22-29. 10.4168/aard.2015.3.1.22.

Diagnostic utility of skin prick test to cooked egg in children with egg allergy

• Jhon J
• Lee KE
• Kim MN
• Hong JY
• Kim MJ
• Kim YH
• Park HB
• Han YK
• Lee HS
• Kim KW
• Sohn MH
• Park JW
• Kim KE

• KMID: 2262272
• DOI: http://doi.org/10.4168/aard.2015.3.1.22

Abstract

PURPOSE
Reliable predictors of tolerance to cooked egg in an egg allergic population are not established. We investigated the usefulness of the skin prick test to cooked egg in children with egg allergy.
METHODS
We studied 36 children with egg allergy. Skin prick tests (SPTs) for the uncooked or cooked form of egg white and egg yolk, whole egg, ovomucoid (OVM), and ovalbumin (OVA) were performed at diagnosis. The reagents of cooked egg for SPT were prepared by baking for 25 minutes in 200 degree oven. We also examined specific IgE levels to whole egg, egg white, egg yolk, OVM, and OVA.
RESULTS
Patients with history of allergic reaction to extensively heated egg showed significantly increased wheal size for cooked egg white (median [interquartile range]), 10.5 [7.0-14.6] vs. 4.2 [0.0-5.6], P<0.001) and OVM (9.6 [7.3-13.8] vs. 5.6 [0.0-7.8], P=0.001) than those without the history. The strongest positive correlation was found between wheal size for cooked egg white and OVM (r=0.788, P<0.001). SPT wheal size for cooked egg white were positively correlated with serum OVM-specific IgE levels (r=0.691, P<0.001). Cutoff value was 7.0 mm in SPT wheal size for cooked egg white, the sensitivity was 73.1% and specificity was 99.0%. SPT for cooked egg white showed significantly higher area under curve than serum egg white specific IgE.
CONCLUSION
Our results suggest that SPT to cooked egg white may be useful predictor of allergic reaction to cooked egg. Further investigations will be needed.

Keyword

Egg hypersensitivity; Skin tests; Egg proteins

MeSH Terms

Area Under Curve
Child*
Diagnosis
Egg Hypersensitivity*
Egg Proteins
Egg White
Egg Yolk
Hot Temperature
Humans
Hypersensitivity
Immunoglobulin E
Indicators and Reagents
Ovalbumin
Ovomucin
Ovum*
Skin Tests
Skin*
Egg Proteins
Immunoglobulin E
Indicators and Reagents
Ovalbumin
Ovomucin

Figure

• 

  Fig. 1 Correlation of skin prick test wheal size for raw egg white with OVA (A) and OVM (B), correlation of skin prick test wheal size for cooked egg white with OVA (C) and OVM (D). SPT, skin prick test; OVA, ovalbumin; OVM, ovomucoid.

• 

  Fig. 2 Correlation of skin prick test wheal size for raw egg white with serum OVA-sIgE (A) and OVM-sIgE (B), correlation of skin prick test wheal size for cooked egg white with OVA-sIgE (C) and OVM-sIgE (D). SPT, skin prick test; OVA, ovalbumin; OVM, ovomucoid.

• 

  Fig. 3 Comparison of receiver operating characteristic (ROC) curves among skin prick test to cooked egg white, serum specific IgE to egg white, egg yolk, ovalbumin, ovomucoid, and whole egg. The area under curve (AUC) of SPT to cooked egg white was 0.89 (95% confidence interval, 0.73-0.97). The AUC was 0.50 (0.33-0.68) for egg white-sIgE, 0.53 (0.36-0.70) for egg yolk-sIgE, 0.60 (0.42-0.76) for OVA-sIgE, 0.72 0.53-0.85) for OVM-sIgE, and 0.54 (0.36-0.71) for whole egg-sIgE. SPT to cooked egg white showed significantly higher AUC than egg white-sIgE (P<0.001), egg yolk-sIgE (P=0.002), OVA-sIgE (P=0.035), and whole egg (P=0.016). SPT, skin prick test; OVA, ovalbumin; OVM, ovomucoid.

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