Food, drug, insect sting allergy, and anaphylaxisThe natural history of egg allergy in an observational cohort
Section snippets
Subjects, study definitions, and procedures
The subjects of this study are a subset with egg allergy of a larger cohort of 512 infants originally enrolled at 3 to 15 months of age at 5 sites (children with egg allergy/total enrolled per site): the Icahn School of Medicine at Mount Sinai, New York (47/106); Duke University Medical Center, Durham, North Carolina (now followed at the University of North Carolina, 20/103); Johns Hopkins University School of Medicine, Baltimore, Maryland (37/109); National Jewish Health, Denver, Colorado
Results
Of the 512 enrolled infants, the cohort with egg allergy consisted of 213 children, of whom 140 were given a diagnosis of egg allergy at baseline. In the remaining 73 children, the diagnosis was categorized as uncertain at the entry visit, but egg allergy was subsequently confirmed at a median age of 23.2 months (interquartile range, 16.1-41.9 months), 10 based on OFC results. Key baseline characteristics are summarized in Table I and Table E2 in this article's Online Repository at //www.jacionline.org
Discussion
Here we describe the natural history of egg allergy in a cohort of children enrolled in an observational study with a diagnosis of egg allergy. We found a resolution rate of almost 50% through age 6 years, which was similar to but slightly slower than the resolution rate of milk allergy in this cohort, which was approximately 50% by age 5 years.18 This result appears to be slightly less favorable than that reported in 58 children by Boyano-Martinez et al,13 who found resolution rates of 50% by
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Supported by National Institutes of Health (NIH)/National Institute of Allergy and Infectious Diseases (NIAID) grant U19AI066738 and U01AI066560. The project was also supported by grants UL1 TR-000154 (National Jewish), UL1 TR-000067 (Mount Sinai), UL1 TR-000039 (Arkansas), UL1 TR-000083 (University of North Carolina) and UL1 TR-000424 (Johns Hopkins) from the National Center for Research Resources (NCRR), a component of the NIH. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.
Disclosure of potential conflict of interest: S. H. Sicherer has received research support from the National Institute of Allergy and Infectious Disease (NIAID), is a board member for the American Board of Allergy and Immunology, has consultant arrangements with Novartis and Food Allergy Research and Education, and receives royalties from UpToDate. R. A. Wood has consultant arrangements with the Asthma and Allergy Foundation of America, is employed by Johns Hopkins University, has received research support from the National Institutes of Health (NIH), and receives royalties from UpToDate. B. P. Vickery has received research and travel support from the NIH/NIAID. S. M. Jones is on the Medical Advisory Board for Food Allergy Research & Education; is a National Advisory Board member for St Louis Children's Hospital Food Allergy Management and Education; has consulted for the Gerson Lehrman Group; has received research support from the NIH, Food Allergy Research & Education, and the National Peanut Board; has a pending grant from the Department of Defense; has received payment for lectures from Abbott Nutrition International, the Kentucky Society for Allergy, Asthma & Immunology, the New England Allergy Society, the American College of Allergy, Asthma & Immunology, Indiana University Medical School and Riley Children's Hospital, the Spanish Society of Allergy & Clinical Immunology, the Oregon Allergy, Asthma & Immunology Society, and the European Academy of Allergology and Clinical Immunology; has received payment for manuscript preparation from the American Academy of Allergy, Asthma & Immunology; and is on the Arkansas Medicaid Drug Review Committee. D. M. Fleischer has received research support from the NIH/NIAID and Monsanto, has consultant arrangements with Sanofi-Aventis, is employed by National Jewish Health, receives royalties from UpToDate, and has received payment for the development of educational presentations from the American Academy of Pediatrics Symposium 2013. P. Dawson has received research support from the NIH. A. W. Burks has received research support from the NIH, the Wallace Research Foundation, and Hycor Biomedical; has board memberships with the Academy of Allergy, Asthma & Immunology, the Hypersensitivity, Autoimmune, and Immune-mediated Diseases Study Section of the NIH, the Food and Drug Administration Food Advisory committee, the Food Allergy & Anaphylaxis Network Research Advisory Board, and the Merck US Allergy Immunotherapy Allergist Advisory Board; has consultant arrangements with Dow AgroSciences, McNeill Nutritionals, Merck, Novartis Pharma AG, Sanofi Aventis US, Schering Plough, Unilever, ExploraMed Development, GLG Research, and Regeneron Pharmaceuticals; is employed by UNC Children's Hospital; has a pending grant from Food Allergy Research and Education; has received payment for lectures from Abbott Laboratories, Mylan Specialty, and the American College of Allergy, Asthma & Immunology; has various US patents related to peanut allergens and methods; has received payment for development of educational presentations from Current Views 2012; and is a minority stockholder in Allertein and Mastcell Pharmaceuticals. A. Grishin has consultant arrangements with Allertein Therapeutics. D. Stablein has received research support from the NIH. H. A. Sampson has received research support from the NIAID, the NIH, and Food Allergy Research Education; is Chair of the PhARF Award review committee; has consultant arrangements with Allertein Therapeutics, Regeneron, and the Danone Research Institute; has received payment for lectures from Thermo Fisher Scientific, UCB, and Pfizer. The rest of the authors declare that they have no relevant conflicts of interest.
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Deceased.
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These authors contributed equally to this work.