The following is a summary of the “Prospective evaluation of tolerance to unheated milk-boiled egg after baked milk-egg tolerance under 2 years,” published in the December 2022 issue of Allergy and Clinical Immunology by Cogurlu, et al.
This study aims to establish how long it takes for children under the age of 2 to develop a tolerance to unheated milk and ordinary eggs, following the development of a tolerance to the baked versions. Patients who had an adverse reaction to raw milk or ordinary eggs were given an oral food challenge with baked milk (BM) or baked egg (BE). Unheated milk and regular egg challenges were given to BM-BE tolerant patients, while BM-BE reactive patients were given challenges at spaced-out intervals of about three months. Atopic dermatitis brought on by food was also covered.
Around 36 of the children had an allergy to raw milk (median age, 7.3 months [IQR, 6.0-13.5]), and 65 had an allergy to normal eggs (median age, 7 months [IQR, 5.8-11.0]). After a mean of 4.0 months, 7 out of 13 children initially tolerant of BM developed tolerance to unheated milk (IQR, 2.0-7.0). At a median of 5.0 months (IQR, 3.0-8.0) after BM tolerance, 12 of 23 BM-reactive children developed an intolerance to warmed milk. After a median of 3 months, 21 of 29 children who were tolerant to BE also became tolerant to conventional eggs (IQR, 1.0-6.0).
After a median of 4.0 (IQR, 2.0-6.8) months of BE tolerance, 16 of 36 children who were BE reactively achieved regular-egg tolerance. Tolerance levels for baked goods were found to vary during the first 2 years of life. After becoming tolerant to BM-BE, up to 65.5% of people with a milk-regular egg allergy and 75.5% of those with a regular egg allergy saw their symptoms improve throughout 4 to 5 months. Tolerance for baked milk and eggs could be a stepping stone toward full tolerance.
Source: sciencedirect.com/science/article/abs/pii/S1081120622005415