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Children with More Severe Eczema Less Likely to Outgrow Milk, Egg Allergy

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Unlike peanuts or seafood, allergies to egg and milk are often outgrown. But new research presented at the 2011 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) sheds even more light on food allergy outcomes, suggesting that children who have more severe atopic dermatitis, or eczema, are less likely to outgrow their milk or egg allergy.

“While our clinical impression has been that the natural course of food allergy might be related to co-existing atopic dermatitis, previous studies had not provided any clear answers to this important question,” explained study author Robert A. Wood, MD, FAAAAI.

Researchers from Duke, Johns Hopkins, Mount Sinai, National Jewish, the National Institute of Allergy and Infectious Diseases (NIAID) and the University of Arkansas enrolled over 500 children between the ages of 3 and 15 months. The participating children had either a convincing history of egg or milk allergy with a positive prick skin test to the trigger food and/or moderate-severe atopic dermatitis and a positive prick skin test to milk or egg.

Eczema severity was scored at baseline and 2 years and was analyzed categorically as none-mild or moderate-severe. Milk and egg allergy was based upon clinical history and food-specific IgE with resolution established by successful ingestion of the trigger food.

During 2 years of observation, 46% of children with none-mild eczema at enrollment outgrew their milk allergy versus only 25% of the children enrolled with moderate-severe eczema. Interestingly, improved eczema severity was not associated with food allergy resolution. Among those with moderate-severe eczema at enrollment who improved to none-mild, just 19% resolved their food allergy compared to 32% who remained moderate-severe.

When looking at egg allergy, 39% of children with none-mild eczema at enrollment outgrew their egg allergy versus 21% that were enrolled with moderate-severe eczema. Of those children who had moderate-severe eczema at enrollment who improved to none-mild over 2 years, 28% resolved their allergy compared with 22% who remained moderate-severe.

“These findings will help clinicians caring for infants with eczema and milk or egg allergy and provide more accurate advice to parents about the likely course of their child’s milk or egg allergy,” added Wood.

 

This study was presented during the 2011 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) on March 18-22 in San Francisco. However, it does not necessarily reflect the policies or the opinions of the AAAAI. A link to all abstracts presented at the Annual Meeting is available at www.annualmeeting.aaaai.org.

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,500 members in the United States, Canada and 60 other countries. Visit www.aaaai.org for more resources and expert advice from allergists.

This article was originally published in Coping® with Allergies & Asthma magazine, March/April 2011.