Risk Factors for Hen’s Egg Allergy in Europe: EuroPrevall birth cohort

Risk Factors for Hen’s Egg Allergy in Europe: EuroPrevall birth cohort:

Publication date: Available online 14 December 2019

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Kate E.C. Grimshaw, Graham Roberts, Anna Selby, Andreas Reich, Indra Butiene, Michael Clausen, Ruta Dubakiene, Ana Fiandor, Alessandro Fiocchi, Linus.B. Grabenhenrich, Jose Ignacio Larco, Marek L. Kowalski, Odilija Rudzeviciene, Nikolaos.G. Papadopoulos, Leonard Rosenfeld, Sigurveig Th. Sigurdardottir, Aline.B. Sprikkelman, Ana.A. Schoemaker, Paraskevi Xepapadaki, E.N.Clare Mills

Abstract

Background

Hen’s egg is one of the commonest causes of food allergy but there are little data on its risk factors.

Objective

To assess the risk factors, particularly eczema, for hen’s egg allergy in the EuroPrevall birth cohort.

Methods

In the pan-European EuroPrevall birth cohort, questionnaires were undertaken at 12 and 24 months or when parents reported symptoms. Children with suspected egg allergy were invited for skin prick testing, specific IgE assessment and double-blind, placebo-controlled food challenge (DBPCFC) as indicated. Each egg allergy case (positive DBPCFC or egg induced anaphylaxis) was allocated up to two age- and country-matched controls.

Results

12,049 were recruited into the EuroPrevall birth cohort. 9,336 (77.5%) were followed until 2 years. 86 infants had egg allergy (84 by DBPCFC) and were matched with 140 controls. Independently associated with egg allergy were past/current eczema (adjusted OR 9.21, 95% confidence interval 2.65-32.04), SCORAD (1.54 per 5 units, 1.28-1.86), antibiotics in the first week of life (6.17, 1.42-26.89) and current rhinitis (3.02, 1.04-8.78). Increasing eczema severity was associated with an increasing likelihood of egg allergy. Eczema was reported to have started 3.6 (SE 0.5) months before egg allergy. Age of introduction of egg into the diet was not associated with egg allergy.

Conclusions

Similar to peanut allergy, eczema was strongly associated with egg allergy development and the association increased with increasing eczema severity. The age of introduction of dietary egg was not a risk factor. The potential role of antibiotics in early life as a risk factor for egg allergy needs further examination.