Effect of moderate to severe atopic dermatitis on the prognosis of egg allergy resolution

Seong Heon Kim,¹ Hye Won Yoo,² Yoon Hee Jo,² Young Mi Kim,² Hye-Young Kim²

Affiliations:
¹ Department of Pediatrics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Children’s Hospital, Yangsan, Republic of Korea
² Department of Pediatrics, Medical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea

Abstract

Background: Few studies have examined the effect of atopic dermatitis (AD) on the resolution of food allergies in Asia, and the predictors of egg allergy resolution are not yet well defined.
Objective: We evaluated whether AD severity could predict the resolution of egg allergy.
Methods: This retrospective cohort study included infants under 24 months of age diagnosed with IgE-mediated egg white allergy. We included subjects who completed a 60-month follow-up. Open oral food challenges (OFCs) and serologic tests were performed at the time of initial diagnosis and at 36 ± 3 and 60 ± 3 months.
Results: We analyzed 68 patients (39 boys and 29 girls). OFCs were performed in 88.2% of the patients. The egg allergy remission rates were 23.5% and 47.1% by 3 and by 5 years of age, respectively. Persistent egg allergy was significantly associated with moderate to severe AD and house dust mite sensitization. Kaplan–Meier curve analysis revealed that patients with moderate to severe AD had higher persistent egg allergy rates than patients with no and mild AD (p = 0.012). Multivariable analysis identified moderate to severe AD as strongly associated with persistent egg allergy (p = 0.001).
Conclusion: In this study, 47.1% of infants had resolved egg white allergies at 60 months. Moderate to severe AD may be a practical and important prognostic factor for persistent egg allergy in clinical settings.
Key words: Egg allergy, atopic dermatitis, food allergy, prognosis, child