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Meet Andrea & Sylvia

Andrea and Sylvia, 3-year-old-girls both with a history of eczema and positive skin-prick test for egg white, go to see their healthcare professional for additional insight into their egg allergies.

Their healthcare professional conducts a full clinical history and physical examination and decides to test using egg white sIgE with a reflex if indicated to egg components.

Patient History – Andrea

Family history

  • None

Personal history

  • Severe eczema since 6–7 months of age 
 
  • Gastrointestinal symptoms
  • Urticaria and wheezing when accidentally eating egg

 

Skin prick test results
Test Type Results
Egg white Whole Allergen +5


Negative skin prick test to milk
 

ImmunoCAPTM test results (kUA /l)
Test Type Results
Egg white Whole Allergen 20


Her previous healthcare professional recommended that Andrea remove egg entirely from her diet. 

Patient History – Sylvia

Family history

  • None

Personal history

  • Severe eczema since 6–7 months of age
  • Gastrointestinal symptoms

  • Urticaria and wheezing when accidentally eating egg

 

Skin prick test results
Test Type Results
Egg white Whole Allergen +4


Negative skin prick test to milk
 

ImmunoCAP test results (kUA /l)
Test Type Results
Egg white Whole Allergen 22


Her previous healthcare professional recommended that Sylvia remove egg entirely from her diet. 

New test results – Andrea

These results, together with Andrea's case history and symptoms, may help her healthcare professional confirm the diagnosis.

ImmunoCAP test results (kUA /l)
Test Type Results
Egg white Whole Allergen 16
Gal d 1 (Ovomucoid) Allergen Component 0.4
Gal d 2 (Ovabumin) Allergen Component 11.1
Gal d 3 (Conalbumin) Allergen Component 0.4
Gal d 4 (Lysozyme) Allergen Component 4.5

New Test results – Sylvia

These results, together with Sylvia's case history and symptoms, may help her healthcare professional confirm the diagnosis.

ImmunoCAP test results (kUA /l)
Test Type Results
Egg white Whole Allergen 19
Gal d 1 (Ovomucoid) Allergen Component 16
Gal d 2 (Ovabumin) Allergen Component 6.9
Gal d 3 (Conalbumin) Allergen Component 0.2
Gal d 4 (Lysozyme) Allergen Component 0.3

Differential Diagnosis – Andrea

Andrea’s low level of sensitization to ovomucoid (Gal d 1) may be an indication of tolerance to fully baked egg.1,2 An open challenge in the clinic with fully baked egg may be performed to confirm the diagnosis. With components, Andrea’s quality of life could have been improved sooner: No need for strict avoidance of all egg products and no cause of stress in the family due to the risk of eating products containing fully baked egg, such as cakes and cookies.

Refined Diagnosis

  • Likely tolerant to baked egg

Healthcare Professional Management Plan

  • Andrea was advised by her healthcare professional to undergo an oral food challenge with a specialist to confirm tolerance to baked egg.

Follow Up

Andrea has successfully passed the oral food challenge for baked egg and has been eating foods containing extensively baked egg since with no issues.

Differential Diagnosis – Sylvia

Sylvia’s significant levels of specific IgE to ovomucoid (Gal d 1) may indicate that she has a risk for reaction to all forms of egg.1,2

Refined Diagnosis

  • Egg allergy

Healthcare Professional Management Plan

  • Dietary restriction to all forms of egg remains

Follow Up

Sylvia has continued to avoid egg in all forms and is doing well. Her autoinjector technique is satisfactory.

The people, places and events depicted in these case studies and photographs do not represent actual patients, nor are they affiliated in any way with Thermo Fisher Scientific.

References
  1. Lemon-Mule H, et al. Immunologic changes in children with egg allergy ingesting extensively heated egg. J Allergy Clin Immunol. 2008;122:977-83 e1.6. 
  2. Ando H, et al. Utility of ovomucoid-specific IgE concentrations in predicting symptomatic egg allergy. J Allergy Clin Immunol. 2008;122:583.