A good quality of life (QOL) can promote overcoming an egg allergy, according to findings from a recent study in Japan. The investigation, which examined factors related to the outcome for egg allergy 1 year after an oral food challenge (OFC), was conducted on 93 children younger than 72 months with egg allergy.
Participants underwent an OFC with a dose of challenge based primarily on the child’s clinical history. When OFC was negative, the caregiver was advised not to give the child more eggs at home than was taken at the challenge dose. When the OFC was positive and the child had mild symptoms, the advice was not to consume more eggs than the threshold dose. When OFC was positive with moderate to severe symptoms, the egg was eliminated from the diet. Parents can increase the amount of egg provided when the child has not had adverse reactions to the initial amount.
After 1 year, investigators surveyed parents of how many eggs their children safely consumed and classified patients as “successful” (group S) if the amount was increased or “unsuccessful” (group U) if it remained the same or reduced; 57 participants (61.3%) were classified as both in group S and 36 (38.7%) as group U. Investigators also assessed QOL of children with a parental questionnaire when OFC was administered and, for 48 patients, in 1-year follow-up.
A comparison of QOL scores showed that all scores in group U were significantly higher than those in group S at baseline, indicating that group S patients had a better initial QOL (the lower the score, the better it is QOL). In the 1-year follow-up, the results remained the same in group U, while in group S, QOL was improved. Factors associated with an increase in follow-up egg intake were lack of concomitant asthma or concomitant atopic dermatitis and a good QOL.
Thoughts from Dr. Farber
One would think that parental instruction to give eggs to children would be direct, but this study shows that it is not for families with lower quality of life. My message for home: Do not underestimate the problems that a difficult situation at home can cause (due to poverty, parental quarrels, illness of other family members, etc.).
1. Hamada K, Nagao M, Imakiire R, et al. Factors associated with the outcome of egg allergy 1 year after the oral food challenge: a good basic quality of life can be beneficial. Pediatrician Allergy Immunol. Published online May 7, 2021. doi: 10.1111 / pai.13534