Re-defining food allergy phenotypes and management paradigm: is it time for individualized egg allergy management?

摘要

Current management of food allergy reflects a changing landscape. In recent years, we have begun to appreciate that different phenotypes of hen's egg white and cow's milk allergy exist and are associated with different prognoses [1], Epidemiologic data suggest that the age of the patient, concurrent atopy, and allergens involved are significant to the prognosis [2]. About 80% of children become tolerant to egg and milk, while only 20% of children become tolerant to peanut [2]. Studies based on general paediatric populations suggest that most children outgrow milk and egg allergies by school age [2, 3]. In contrast, among children with multiple food allergies evaluated at a referral centre, many had persistent egg and milk allergy well into their teenage years [4, 5]. The longer a food allergy persists, i.e. into late teenage and early adult years, the less likely the patient will become tolerant [2].