ORLANDO, Fla. — Patients safely tolerated increased amounts of protein content in milk and egg oral food challenges, according to data presented at the American Academy of Allergy, Asthma and Immunology 2012 Annual Meeting.
While oral food challenges (OFC) occupy a vital role in evaluating patients with suspected food allergy or establishing tolerance, indications for food challenges are not standardized and based instead on the likelihood of a patient achieving tolerance. To establish a protocol for OFC, researchers compared the outcomes of OFC after increasing the amount of protein consumed.
In the study, 63 patients who underwent milk and egg OFC from 2006 to 2007 were compared with 38 patients who underwent milk and egg OFC from January to July in 2011. The first group ingested 0.54 g cow’s milk and 6.1 g egg while the second group ingested 6.8 g cow’s milk and 13.6 g eggs. Pass rate for participants was defined as a lack of immediate or delayed symptoms following OFC.
According to the study, similar milk OFC failure rates occurred in both groups: 20% (n=6/30) vs. 18% (n=3/22). A reduction in egg OFC failure rates from 14% (n=6/33) to 0% (n=0/16) was seen, despite the increase in protein content.
“Our patients did not experience any increase in risk and failures or reactions to food challenges when they were challenged to milk or egg at a larger dose quantity — milk was administered four times greater quantity than previous and egg administered two times greater quantity,” Sara A. Lowe, RN, APNP, told Infectious Diseases in Children.
Reactions observed or reported were similar in both groups including pruritus (n=7), emesis (n=1), urticaria and angioedema (n=13), cough and wheeze (n=2). Failed OFC were treated successfully with cetirizine in all but one patient, who required epinephrine and prednisone for anaphylaxis without further sequelae.
“In addition, our study demonstrated that there was no increased risk of failures. Most OFC failures remained the same across groups, including cutaneous, gastrointestinal and respiratory symptoms – however, respiratory symptoms were quite rare,” Lowe said.
For more information:
- Lowe SA. #216. Increase in food protein consumed during milk and egg oral food challenges are not associated with increase in failures. Presented at: the 2012 AAAAI Annual Meeting; March 2-6, 2012; Orlando, Fla.