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Egg allergy in infancy predicts respiratory allergic disease by 4 years of age


Dr S. H. Arshad, The David Hide Asthma and Allergy, Research Center, St. Mary’s Hospital, Newport, Isle of Wight PO30 5TG, UK


Sensitization to hen’s egg early in life has been proposed as a predictor for respiratory allergic disease during childhood. However, symptomatic egg allergy in infancy has not been studied in this context. In 1989, a cohort of consecutive births was recruited. Data on family history of atopy and environmental factors were collected. At 4 years of age, 1218 children were seen of whom 981 were skin-prick tested with a range of food and aero-allergens. Of the 1218 children, 29 (2.4%) had suffered symptomatic egg allergy (20 during infancy). Egg allergy in infancy was associated with increased respiratory (asthma, rhinitis) allergic disease (odds ratio [OR] 5.0, 95% confidence intervals [CI] 1.1–22.3; p < 0.05) at 4 years of age, with a positive predictive value (PPV) of 55.0%. The addition of infantile eczema to egg allergy increased the PPV to 80% whereas the addition of family history of atopy had no effect. Egg allergy also increased aero-allergen sensitization (OR 6.1, CI 1.1–37.5; PPV 61.1%; p < 0.05). As a predictor for respiratory allergic disease and aero-allergen sensitization, it carried a high specificity but poor sensitivity. Hence, egg allergy in infancy, especially when coexisting with eczema, increases respiratory allergic symptoms and aero-allergen sensitization in early childhood.