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Food Allergies/Adult-onset egg allergy

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Question
Dr. Pearson,

I have an adult-onset egg allergy/sensitivity.  I began having a problem only 5 years ago, at the age of 42.  I primarily used to enjoy eggs in fried form, such as in French toast.  I ate that particular dish so often that one might suspect my problem came from overexposure.


When I last ate French toast 5 years ago, my mouth began to feel "tingly".  I tried using a different batch of eggs but had the same problem.  Also the same problem eating crepes recently.

I have no problem eating commercially-prepared baked goods which contain eggs, such as store-bought cookies or muffins.

Any ideas?  Eggs were a primary source of protein for me so I am quite anxious to be able to tolerate them again.  

Thanks very much.

Answer
You ask an extremely interesting question. I know of no published case of egg allergy developing beyond infancy. But at the same time I believe what you report. There has to be a good explanation. But at present, I don't know what it is.

Egg allergy to avine (bird) eggs is very common in infancy and is usually outgrown. Not always: My mother had egg allergy all her life and when invited to afternoon tea, her party piece was telling her hostess how many eggs she had used in making the cake. She placed one crumb under her tongue before eating. She would then eat a 1-egg cake slice with great enjoyment and no after-effects with great enjoyment. A two-egg cake gave her diarrhoea and vomiting. With a 3-egg cake, she had anaphylaxis!

The main allergen is ovalbumin and the essential allergen is common to the eggs of all birds (and quite possibly dinosaurs!). "Cross-reactivity" between species is the rule. The allergen is not usually destroyed by cooking. Consequently, your description of reacting to some egg-containing foods is atypical.

There are two main possibilities : 1. That the clinical reactions you get are purely related to allergen dosage. Any reaction is proportional to the combination of dosage X level of sensitivity. Clearly these are variable independently. Therefore what you describe could be related to this. The best way of testing clinical sensitivity is to first do ovalbumin skin tests. These are vastly superior to circulating antibody levels. Follow that with graded open (i.e. not hidden) ovalbumin feeding tests. For complete assurance of what is to you an essential protein source, if open provocation is positive then it should be followed by double-blind provocation for total certainty. The degree of sensitivity varies according to how often that food is eaten. So: One patient of mine could eat a lobster once a year with enjoyment and no problem. Second one within 1-3 months and he got life-threatening anaphylaxis. Between 3-12 months he just got diarrhoea and/or vomiting.  

2. You do not say where you live, but if it is the USA or other countries where domestic animals/birds are primarily fed artificial diets, anything could be in there. For instance, in the USA cows are often fed grain. This changes the fatty acid composition of bovine milk, cheese and meat products into heart-attacks waiting to happen. Purely grass fed animals produce milk and cheese with fatty acids more likely to prevent heart disease. I've measured these things myself, but work confirming this has been published from many countries in Europe. What goes into factory farmed eggs worries me so much, I won't eat them.

You are very welcome to get back to me once you have considered the above. Mark it private if you wish.

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David Pearson

Expertise

Any in the field I believe. Only experience of questions that get asked will tell.

Experience

I am a retired medical academic from the UK. I have done major research on Food Allergy and have been a government adviser in the area. 30 years experience running an allergy clinic. And undergraduate and post-graduate teaching.

Organizations
Well, apart from the FRCP, I'm no longer active in the area. I'm too busy writing books. And I no longer have the cash to go to international meetings. But was active in many.

Publications
Will 120 scientific papers help? Chapters in books. Patient advisory materials. Magazine articles. TV appearances. Live and recorded. National and international invited lectures, etc. It was my job for 40 years. Do you think I count!

Education/Credentials
MD, PhD, Postgraduate Diplomas etc. Fellow of the Royal College of Physicians. etc. But I don't want that put out on the net! Just to let you know!

Awards and Honors
irrelevant.

Past/Present Clients
Too many to count, patients of course and a large number of all sorts of corporate consultancies and considerable work as an expert witness in the Courts. I'm volunteering because your Greek expert has been so helpful, I thought I'd offer something back.

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