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Incidence and natural history of hen's egg allergy in the first 2 years of life-the EuroPrevall birth cohort study

Incidence and natural history of hen's egg allergy in the first 2 years of life-the EuroPrevall birth cohort study
Incidence and natural history of hen's egg allergy in the first 2 years of life-the EuroPrevall birth cohort study
BACKGROUND: Parents and health staff perceive hen's egg allergy (HEA) as a common food allergy in early childhood, but the true incidence is unclear because population-based studies with gold-standard diagnostic criteria are lacking.

OBJECTIVE: To establish the incidence and course of challenge-confirmed HEA in children, from birth until the age of 24 months, in different European regions.

METHODS: In the EuroPrevall birth cohort study, children with a suspected HEA and their age-matched controls were evaluated in 9 countries, using a standardized protocol including measurement of HE-specific immunoglobulin E-antibodies in serum, skin prick tests, and double-blind, placebo-controlled food challenges (DBPCFC).

RESULTS: Across Europe, 12 049 newborns were enrolled, and 9336 (77.5%) were followed up to 2 years of age. In 298 children, HEA was suspected and DBPCFC was offered. HEA by age two was confirmed in 86 of 172 challenged children (mean raw incidence 0.84%, 95% confidence interval (95% CI) 0.67-1.03). Adjusted mean incidence of HEA was 1.23% (95% CI 0.98-1.51) considering possible cases among eligible children who were not challenged. Centre-specific incidence ranged from United Kingdom (2.18%, 95% CI 1.27-3.47) to Greece (0.07%). Half of the HE-allergic children became tolerant to HE within 1 year after the initial diagnosis.

CONCLUSIONS: The largest multinational European birth cohort study on food allergy with gold-standard diagnostic methods showed that the mean adjusted incidence of HEA was considerably lower than previously documented, although differences in incidence rates among countries were noted. Half of the children with documented HEA gained tolerance within 1 year postdiagnosis.
children, egg allergy, epidemiology
0105-4538
350-357
Xepapadaki, P.
70aee30c-cf02-40a8-9773-5e13bc3dad43
Fiocchi, A.
611be05e-a0de-4e2d-b4d2-b762c35c8551
Grabenhenrich, L.
c0078333-0505-4c5c-9cec-9cccca6207d3
Roberts, G.
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3
Grimshaw, K.E.C.
766b6cf0-347a-447d-aeab-f07366f8ce28
Fiandor, A.
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Larco, J.I.
446dfbe8-4315-477f-8f4b-6f87f132f540
Sigurdardottir, S.
a291829f-e7fd-4e33-b36a-db18c7a92a5a
Clausen, M.
cc2c5328-d0a9-4a65-a51a-cb22c1a5e371
Papadopoulos, N.G.
fac5aea9-7ee2-4579-90c8-e547b6a4bdf7
Dahdah, L.
cbe35911-4b9c-4763-a27c-9140538f5cb5
Mackie, A.
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Sprikkelman, A.B.
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Schoemaker, A.A.
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Dubakiene, R.
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Butiene, I.
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Kowalski, M.L.
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Zeman, K.
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Gavrili, S.
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Keil, T.
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Beyer, K.
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Xepapadaki, P.
70aee30c-cf02-40a8-9773-5e13bc3dad43
Fiocchi, A.
611be05e-a0de-4e2d-b4d2-b762c35c8551
Grabenhenrich, L.
c0078333-0505-4c5c-9cec-9cccca6207d3
Roberts, G.
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3
Grimshaw, K.E.C.
766b6cf0-347a-447d-aeab-f07366f8ce28
Fiandor, A.
59859001-873b-4501-8f16-78b5abfce12b
Larco, J.I.
446dfbe8-4315-477f-8f4b-6f87f132f540
Sigurdardottir, S.
a291829f-e7fd-4e33-b36a-db18c7a92a5a
Clausen, M.
cc2c5328-d0a9-4a65-a51a-cb22c1a5e371
Papadopoulos, N.G.
fac5aea9-7ee2-4579-90c8-e547b6a4bdf7
Dahdah, L.
cbe35911-4b9c-4763-a27c-9140538f5cb5
Mackie, A.
11175374-85fe-4e5e-ad84-d212ee7767ac
Sprikkelman, A.B.
639e5245-5fac-480d-a203-fb920ceb58b0
Schoemaker, A.A.
920c0551-37a4-4044-ad92-26308fc5f2ad
Dubakiene, R.
363ddaa7-d0ad-4942-8855-e7f5393836dd
Butiene, I.
c834aa22-e000-438d-91e8-0283fbcafaa6
Kowalski, M.L.
3cd2d0df-36a4-46b0-a3d3-6978b26923da
Zeman, K.
48c60d5d-cede-4f10-93b6-0be28f98ebd3
Gavrili, S.
da6cd202-178e-471c-8802-a62b67729d4e
Keil, T.
7b3edd35-b6fe-463c-a33c-8d8efa687686
Beyer, K.
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Xepapadaki, P., Fiocchi, A., Grabenhenrich, L., Roberts, G., Grimshaw, K.E.C., Fiandor, A., Larco, J.I., Sigurdardottir, S., Clausen, M., Papadopoulos, N.G., Dahdah, L., Mackie, A., Sprikkelman, A.B., Schoemaker, A.A., Dubakiene, R., Butiene, I., Kowalski, M.L., Zeman, K., Gavrili, S., Keil, T. and Beyer, K. (2016) Incidence and natural history of hen's egg allergy in the first 2 years of life-the EuroPrevall birth cohort study. Allergy, 71 (3), 350-357. (doi:10.1111/all.12801). (PMID:26514330)

Record type: Article

Abstract

BACKGROUND: Parents and health staff perceive hen's egg allergy (HEA) as a common food allergy in early childhood, but the true incidence is unclear because population-based studies with gold-standard diagnostic criteria are lacking.

OBJECTIVE: To establish the incidence and course of challenge-confirmed HEA in children, from birth until the age of 24 months, in different European regions.

METHODS: In the EuroPrevall birth cohort study, children with a suspected HEA and their age-matched controls were evaluated in 9 countries, using a standardized protocol including measurement of HE-specific immunoglobulin E-antibodies in serum, skin prick tests, and double-blind, placebo-controlled food challenges (DBPCFC).

RESULTS: Across Europe, 12 049 newborns were enrolled, and 9336 (77.5%) were followed up to 2 years of age. In 298 children, HEA was suspected and DBPCFC was offered. HEA by age two was confirmed in 86 of 172 challenged children (mean raw incidence 0.84%, 95% confidence interval (95% CI) 0.67-1.03). Adjusted mean incidence of HEA was 1.23% (95% CI 0.98-1.51) considering possible cases among eligible children who were not challenged. Centre-specific incidence ranged from United Kingdom (2.18%, 95% CI 1.27-3.47) to Greece (0.07%). Half of the HE-allergic children became tolerant to HE within 1 year after the initial diagnosis.

CONCLUSIONS: The largest multinational European birth cohort study on food allergy with gold-standard diagnostic methods showed that the mean adjusted incidence of HEA was considerably lower than previously documented, although differences in incidence rates among countries were noted. Half of the children with documented HEA gained tolerance within 1 year postdiagnosis.

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More information

Accepted/In Press date: 25 October 2015
e-pub ahead of print date: 29 October 2015
Published date: March 2016
Keywords: children, egg allergy, epidemiology
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 388717
URI: http://eprints.soton.ac.uk/id/eprint/388717
ISSN: 0105-4538
PURE UUID: 424bf6dc-b3ba-4fd4-b730-6c00f290c4d9
ORCID for G. Roberts: ORCID iD orcid.org/0000-0003-2252-1248

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Date deposited: 02 Mar 2016 12:23
Last modified: 18 Feb 2021 17:04

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Contributors

Author: P. Xepapadaki
Author: A. Fiocchi
Author: L. Grabenhenrich
Author: G. Roberts ORCID iD
Author: K.E.C. Grimshaw
Author: A. Fiandor
Author: J.I. Larco
Author: S. Sigurdardottir
Author: M. Clausen
Author: N.G. Papadopoulos
Author: L. Dahdah
Author: A. Mackie
Author: A.B. Sprikkelman
Author: A.A. Schoemaker
Author: R. Dubakiene
Author: I. Butiene
Author: M.L. Kowalski
Author: K. Zeman
Author: S. Gavrili
Author: T. Keil
Author: K. Beyer

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