Egg sensitization and outcomes in children with egg FPIES
What it found
In children with egg FPIES, those who were sensitized to egg were more likely to have immediate allergic symptoms when egg was reintroduced, but sensitization did not delay tolerance.
This was a chart review of 153 children at two allergy clinics.
What they found
Studies in people
Sensitization rate
Of 124 children tested for egg allergy, 56 (45.2%) showed evidence of sensitization at some point. Sensitized children were more likely to have other IgE-mediated food allergies.
Baked egg tolerance
Of 48 children who tried baked egg, 30 (62.5%) tolerated it after a median of 20.5 months of egg avoidance. Including those who already tolerated baked egg at their first visit, 22.9% of the whole group was tolerant to baked egg.
Time to tolerance
Sensitization did not delay the time it took to tolerate baked or unbaked egg. The median age of tolerance to unbaked egg was similar in sensitized, non-sensitized, and untested children.
IgE symptoms on reintroduction
All children who had immediate allergic symptoms (like hives or vomiting within an hour) during egg reintroduction were sensitized. No immediate symptoms occurred in non-sensitized or untested children.
Phenotype switch
At least 9.2% of the children switched from FPIES to an IgE-mediated food allergy to egg. This may be an underestimate because many children did not have follow-up testing.
What the authors conclude
“Our data suggest that testing for allergic sensitization to egg may help stratify patients with FPIES at risk for future IgE-mediated symptoms.”
Also in their conclusions
- They suggest that testing for allergic sensitization to egg may help identify patients with FPIES who are at risk for future IgE-mediated symptoms.
- They advise that future prospective studies should evaluate the best timing and predictive value of skin testing in patients with FPIES and the usefulness of introducing baked egg in patients with egg FPIES.
How it was done
The authors wanted to understand whether testing for allergic sensitization to egg could help predict outcomes, such as time to tolerance and reactions during reintroduction, in children with egg FPIES.
They reviewed the medical charts of 153 children diagnosed with egg FPIES by an allergist at two academic pediatric allergy clinics from 2008 to 2023. They looked at reaction characteristics, allergy testing results, baked egg tolerance, and food reintroduction outcomes.
What it can’t tell you
- This was a retrospective chart review, so it can show links but not prove cause and effect.
- The study relied on existing medical records, which were sometimes incomplete, and testing and reintroduction practices varied between clinics.
- The results may not apply to all children with egg FPIES, especially those seen outside academic allergy clinics.
Who paid
- Funding
- Funded by NIAID NIH HHS (from the PubMed record).
- Conflicts
- Conflicts of interest: The authors declare they have no relevant conflicts of interest.
- Authors work at
- Children's Hospital of Philadelphia, Pa; University of Pennsylvania, Pa; Dell Children's Medical Center, Tex
The paper
- Title
- Clinical Significance of Egg Sensitization in Pediatric Food Protein-Induced Enterocolitis Syndrome to Hen's Egg
- Type
- Study
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Navard-Keck A, Horn S, Brown-Whitehorn TF, Ruffner MA, Varshney P (2025). Clinical Significance of Egg Sensitization in Pediatric Food Protein-Induced Enterocolitis Syndrome to Hen's Egg. The journal of allergy and clinical immunology. In practice. doi:10.1016/j.jaip.2025.05.055Free full textPubMed 40484346DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error