Egg allergy

from Wikipedia, the free encyclopedia

The egg protein allergy is a food allergy , the main triggers of which are ovomucoid (the most important allergen ), ovalbumin , ovotransferrin and lysozymes . These are the most important in the egg contained egg allergens .

Causes, frequency

The prevalence of a chicken egg protein allergy is reported very differently. In South Korea, it is likely to be the most common form of food allergy. In Germany, according to the HEAP study, the prevalence in children is 4.3% (confirmed by a double-blind, randomized, placebo-controlled food challenge).

In 35% of children with food allergies as well as children with atopic dermatitis it could be a decisive trigger (Crespo et al. 1995, Resano et al. 1998). The frequency in food allergic adults is given as twelve percent. In a French study from 1995, eggs were identified as the cause of food-induced anaphylactic shocks in 11.6% .

Allergy and vaccination

Only manifest chicken egg protein allergy is of clinical significance in various vaccinations that are carried out with vaccines based on chicken embryos. In general, however, it must be said that, with the exception of the yellow fever vaccine and the flu vaccines produced in chicken embryos, due to the small, non-allergenic amounts of chicken protein they contain, severe urticarial rashes after eating chicken eggs or chicken meat in the past are not a general reason for exclusion for the currently common ones Represent vaccinations. Therefore, children with a known egg white allergy can safely and easily with z. B. be vaccinated with the MMR vaccine. At most, in children with a clinically very severe chicken egg protein allergy (e.g. anaphylactic shock after consuming the smallest amounts of egg protein), it is recommended that the vaccination be carried out under special protective measures and subsequent observation (if necessary in a hospital).

In the case of influenza vaccines, allergy sufferers have the option of switching to chicken protein-free vaccines or vaccines with less than 0.06 µg chicken protein / 0.5 ml dose. The proportion of ovalbumin has fallen since 2016 to ≤ 0.024 µg ovalbumin / 0.2 ml dose.

Since chicken embryos are used in the production of vaccines and these embryonic proteins differ from those of "adult" chickens, the allergenic potential of chicken egg protein contained in vaccines is to be classified as low, since cross-allergies are also rare.

therapy

Research is now being conducted into using oral immunotherapy to hyposensitize children with egg protein allergies. In a double-blind study, the treatment worked in three quarters of the patients. Unfortunately, after the end of the therapy phase, the therapeutic effect lasted longer than 24 months in only 11 of 29 patients. This form of therapy cannot (yet) be generally recommended because there are no standard protocols, no therapy guidelines and, overall, only small studies with low evidence quality are available.

Individual evidence

  1. ^ A b Matthias Besler, Yoshinori Mine: Major Hen's Egg White Allergen: Ovomucoid (Gal d 1). In: Internet Symposium on Food Allergens. 1 (4), 1999, pp. 137-146.
  2. ↑ Allergen Data Collection: Hen's Egg White (Gallus domesticus). In: Internet Symposium on Food Allergens. 1 (1), 1999, pp. 13-33.
  3. ↑ Jae-Won Oh et al .: Epidemiological change of atopic dermatitis and food allergy in school-aged children in Korea between 1995 and 2000 . In: Journal of Korean Medical Science . tape 19 , no. 5 , October 2004, p. 716–723 , doi : 10.3346 / jkms.2004.19.5.716 , PMID 15483350 , PMC 2816337 (free full text).
  4. ↑ Veronika Schwarz: Prevalence of egg allergy before complementary food and evaluation of possible risk factors. Dissertation. Medical Faculty of the Charité - Universitätsmedizin Berlin, December 11, 2015.
  5. ↑ P. Fritsch: Dermatology and Venereology . 2nd Edition. Springer, 2004, ISBN 3-540-00332-0 .
  6. ↑ a b Is vaccination with MMR vaccine possible for people with egg white allergy? RKI, December 15, 2016, accessed on November 6, 2019 .
  7. ↑ a b Influenza: the green book, chapter 19. Public Health England, April 23, 2019, p. 19 , accessed on November 6, 2019 .
  8. ↑ J. Liese, D. Reinhardt: vaccinations and allergies. In: Heinz Spiess, Ulrich Heininger (Ed.): Impfkompendium. 6., completely revised and exp. Edition. Georg Thieme Verlag, 2005, ISBN 3-13-498906-9 , p. 55 ff.
  9. ^ A. Wesley Burks et al .: Oral immunotherapy for treatment of egg allergy in children . In: The New England Journal of Medicine . tape 367 , no. 3 , July 19, 2012, p. 233-243 , doi : 10.1056 / NEJMoa1200435 , PMID 22808958 , PMC 3424505 (free full text).
  10. ↑ O. Romantsik et al .: Does giving daily small, steadily Increasing Amounts of egg protein help people with egg allergy? Cochrane, April 20, 2018, accessed November 6, 2019 .