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Persistent egg allergy: Evaluate and enforce the risk

Thomas, a 17-year-old boy with a history of egg allergy, visits his healthcare provider following two recent emergency room visits due to reaction to egg. Thomas has stopped carrying his epinephrine autoinjector and his mother is worried that he doesn’t take his allergy seriously.

Thomas’ healthcare provider conducts a full clinical history and physical examination and decides to test him for sensitization to egg white and components to help reinforce the seriousness of his egg allergy diagnosis.
 

Thomas has had severe reactions due to an egg allergy. Will specific IgE blood testing help him take his allergy seriously?

Patient History

Family History

  • None

Thomas’ Personal History

  • Thomas was rushed to the emergency room at age 2 when he experienced difficulty breathing, an itchy mouth and swollen lips after eating egg.
  • A presumptive diagnosis of egg allergy was made, but no testing was done.
  • Thomas was diagnosed with moderate persistent asthma at the age of 5.

Thomas’ ImmunoCAPTM Test Results

These results together with this patient's case history and symptoms, help confirm the diagnosis.

 

ImmunoCAP Test Results (kUA/I)

Test

Type

Thomas’ Results

Egg white

Whole Allergen

56.9

Gal d 1 (Ovomucoid)

Allergen Component

10.73

Gal d 2 (Ovalbumin)

Allergen Component

9.74

Differential Diagnosis

Thomas’ test results revealed that he was highly sensitized to ovomucoid, which is associated with an increased risk of systemic reaction to all forms of egg.1

REFINED DIAGNOSIS

  • Sensitized to egg whites.
  • Sensitized to ovalbumin and ovomucoid proteins.
  • Risk of reaction not reduced by extensively baking egg.

 

HEALTHCARE PROVIDER MANAGEMENT PLAN

  • Thomas was advised that his sensitization to ovomucoid means he will likely react to egg in any and all forms.
  • Thomas' healthcare provider reinforced the importance for Thomas to avoid accidental or purposeful ingestion of eggs and products containing eggs.
  • Thomas' healthcare provider advised him to always carry his emergency adrenaline autoinjector.

 

FOLLOW UP

  • Thomas has had no further episodes, and is fit and well. His healthcare provider checks his autoinjector technique and is satisfied.

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. Caubet J-C, Wang J. Current understanding of egg allergy. Pediatric clinics of North America. 2011;58(2):427-443. doi:10.1016/j.pcl.2011.02.014.