Passed Cooked Egg challenge Failed Raw Egg Challenge - Doctor's advice confusing

[Mom2DD]

Hello All,

  Great News my DD somewhat passed her egg challenge, she ate it no problem in baked goods, she could eat  both the white and yellow of a hard boiled egg!!  However, she started to react when she was given raw egg.  The Doctor told us she can eat eggs in baked goods and that is all.  He told us she cannot eat cooked eggs, or eggs in pasta, pancakes, mayonnaise etc..  I do not want to take chances at all, but she was so excited about trying fresh pasta, including raviolis.    All ravioli's have a may contain or contains eggs alert on them.   A hard boiled egg is cooked at 100 Celcius, and she had no reaction to it, so I do not see why she could not have pasta with eggs in it, since pasta is cooked at the same temperature. 

When I asked for further clarification, he indicated that she can eat items that have eggs in them if they are cooked in the oven, but not raw eggs or items cooked on the stove.  So I asked if I cooked the item first on the stove and then baked it would it be okay, he just mumbled something.  I should share, that we moved to a new area, and this new Doctor is a Pediatrician who has alot of patients with allergies, however he is not an Allergist, like her previous Doctor.  So I am not too sure if he is up on all the latest.

Does anyone else have children in this situation, passed the boiled egg test, but failed the raw egg?  If so, what does your child eat in regards to eggs?  What was the advice of their Allergist?

Thanks,

Mom2DD

[twinturbo]

When you say she reacted when she ate raw egg

Define 'raw egg' given at challenge in terms of in what, how much and what the reaction was. Eating a boiled albumin is an intense amount of protein. Mayonnaise and eggy frosting and the like I can see but eating straight albumin in that concentration is a good amount of tolerance.

Also, I'm more than a little perturbed that a pediatrician is performing in office food challenges on children with established LTFA. Not directed at you at all, Mom.

[maeve]

I'm with TT about the pediatrician is performing food challenges. I can tell you that the baked egg challenge was nothing like the one my daughter had. Heck, if she could tolerate a hard boiled egg, I think she would likely be declared to have outgrown her allergy. The baked egg challenge (at least at Hopkins) is a challenge to determine a safe dose at which to introduce thoroughly baked eggs (no casseroles, pancakes, waffles, or brownies in Hopkins' protocol); that typically means muffins or cupcakes.

I'd get a referral to an allergist.

[CMdeux]

Yeah--- what both of them said.

I'm kind of horrified that someone with anaphylaxis Hx would be given a raw egg challenge without A LOT of history of tolerance first....

much less that it would be done outside of a hospital setting.  :eek:


I'd think, based on what you've shared, that you're PROBABLY in the clear for pretty much anything BUT straight out-and-out EGGY stuff or things which are not fully cooked.

KWIM?

So no meringue, royal icing, or mayo in your future.  No quiche, no omelettes.  But it truly sounds like pretty much everything up TO that is likely to be well-tolerated at this point.

No sense in jumping right TO that sort of thing, though.

I will share what we've found-- and my DD is still pretty highly allergic, as we discovered a week or so ago when we tried COOKING eggs in the house for the first time in 14y--

pastas on shared lines? Yes.
shared lines, bread and candy?  yes, mostly.

Beverages on shared lines?  mostly NOT.

I would definitely try some fun pastas-- even if you don't jump right to egg-containing varieties like raviolis, shared-lines stuff SHOULD be fine.

If you wanted to venture out past that, lasagna noodles or other eggy varieties that are COOKED IN THE OVEN for long periods of time would be my first strategy.

Well, aside from the obvious-- baked goods.  Meatloaf, for example.   

[Mom2DD]

Thank You for your responses, very helpful!

I should note, that the Doctor's office is right next to the hospital and they consider it part of the hospital although it is a separate building.  The food challenge was a little different then what I had expected. We were told and expected to challenge her only to eggs in baked items.  Not sure what changed but they wanted to challenge her as well to cooked eggs (hard boiled) and uncooked when we got there. 

For the raw egg, they took uncooked egg yolk and dabbed about 5ml on her lip, after 30 minutes they then put 5ml on her tongue.  After 30 minutes, they then smeared about 1 tsp of uncooked yolk on a cracker and told her to eat it.  At which point, her lower lip began to swell and she became itchy on her neck.

For the hard boiled egg - they started with putting a small amount of cooked yolk on her lip, waited 30 minutes for a reaction, and then they placed about a tsp on her tongue and was told not to swallow it.  That was very difficult.  After 30 minutes she was given 1 tsp of yolk to eat.  They then repeated the same process with the cooked egg white.  However it was small amounts and they never increased those amounts.  I had expected that once she tolerated 1 tsp of both the hard boiled yolk and egg white they would give her increased amounts of them say 1 tablespoon and then 1/4 cup.  They instead moved on to the uncooked egg and which point she reacted.

Thanks for the advice, I will look to get a referral to Pediatric Allergist.

Mom2DD

[CMdeux]

Yeah-- talk it over with a good pediatric FOOD allergist.  My guess is that you'll get the "all-clear" for cooked egg-- period.

It's too bad that you don't really know how much cooked egg she might tolerate, but that challenge sounds pretty extreme in terms of allergenicity and concentration.