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Positive Oral Food Challenge, Shall We Stop or Continue?
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Sonsoles Infante, MD, Maria Elisa Caralli, MD, Alexandra Yago, MD, Alberto Alvarez-Perea, MD, Victoria Fuentes-Aparicio, MD, Lydia Zapatero, MD, PhD
Rationale:

Oral food challenge (OFC) is a useful tool in both diagnosis and corroborate the persistence of food allergy

With a positive OFC, an avoidance diet seems logical. Oral Immunotherapy (OIT) with cooked egg gives us an alternative approach.

Methods:

We performed an OIT protocol with cooked egg (boiled egg or french omelette).

 Children who tolerated at least 1/4 of  boiled egg or french omelette during the OFC were recruited into the OIT protocol.

 The starting dose was established at 50% of the threshold dose. All dose increases were performed at the hospital with daily maintenance at home.

 Once they reached tolerance to boiled egg or french omelette they incorporated it  into their diet.  Periodically follow up was done. Finally, tolerance to raw egg was tested in order to determine how many of them had developed complete tolerance

Results:

Forty-one egg allergic children were included in OIT. Mean age 4 years old. All of them succesfully completed the OIT in an average of 5 visits.

Only 9 children had reactions during the OIT, mostly mild. Only one developed anaphylaxis.

In 30 children, an OFC with raw egg was performed. Twenty-seven achieved complete tolerance (median 13,48 months, range 4-32) 

Conclusions:

It is important to revaluate the persistency of egg allergy. With a positive OFC, is not always necessary to indicate an exclusión diet, thus a quick OIT with cooked egg can be performed.