All issues > Volume 35(9); 1992

Original Article

J Korean Pediatr Soc. 1992;35(9):1226-1235. Published online September 15, 1992.

Infantile Asthma and Egg Allergy

Sung Hee SH Lim¹, Hye Sun HS Lee¹, Young Min YM Ahn¹

¹Department of Pediatrics, Kangnam General Hospital Public Corporation, Seoul, Korea

Abstract

Egg is known to be the most common food allergen, which induces various symptoms such as atopic dermatitis, bronchial asthma, urticaria, angioedema, gastrointestinal symproms & anaphylaxis, especially during infancy. To evaluate the clinical course & significance of egg allergy in infantile asthma, we performed diagnostic study on 44 patients who were diagnosed as infantile asthma in our hospital from 1988 to 1990. 12 patients were diagnosed as egg allergy. The results were as follows 1) The incidence of egg allergy among infantile asthma was 27.2% and male predominated. The ages at diagnosis of egg allergy were 3 to 21 months and incidence was higher in younger age group. 2) There was no exposure history to egg in 25% of patients suggesting sensitization via intrauterine or breast milk routes. 3) Accompanying symptoms of positive skin reactors to egg white among infantile asthma patients were as follows ; atopic dermatitis 100%, urticaria 42%, GI symptoms 33%, allergic rhinitis 25%, allegic conjunctivitis 17%. 4) Total eosinophil count and IgE were remarkeably elevated and RAST score for egg white were positive(1-3class) in all who were tested. The skin test positivities to other common allergens were as follows ; milk 25%, Dermatophagoides farinae 42%(→58%), Dermatophagoides pteronyssinus 42%(→66%), bean 27%, wheat 17%, pork 11%, fish 9% etc. (During follow up periods, 4 cases were newly sensitized to D. farinae and/or Dermatophagoides pteronyssinus after 2,6,8,19 months respectively) 5) Egg provocation test were performed on 9 cases and showed positive results in 8 cases(89%). 6) After egg elimination diet, clinical symptoms improved in all patients including remarkable improvement of atopic dermatitis, but respiratory symptoms of mild to moderate degree persisted in majority of patients. 7) Tolerance to egg was developed in 7 cases at the age of 13~30 months, but there were little changes in skin reactivities to egg. 8) Egg derived vaccines(ex. MMR or influenza)were administered in 10 cases, majority of them didn't have adverse reaction to vaccination except 1 case who had developed asthma symptoms after MMR vaccination. Skin test to egg is essential for patients with infantile asthma accompaning atopic dermatitis and IgE level is usually elevated in these patients. If they show positive reactions to egg white, they have high risk of sensitizatio to other antigens including house dust mite. Early detection and early elimination of egg may prevent sensitizatio to house dust mite and retard the appearance of symptoms, but further study is required. There is probability of development of tolerance to egg at the age of 1 to 3 years, so rechallenge test is needed yearly. Although one may have egg allergy, if he or she doesn't have history of anaphylaxis, he or she can be given egg derived vaccine safely after skin test with vaccine.

Keywords :Infantile asthma, egg allergy