Is hen's egg a significant allergen in adults too? Findings from an investigation into food allergy prevalence.

Abstract

Introduction: Data on adult food allergies (FAs) remain limited compared to the pediatric population, and this study investigates the prevalence and clinical characteristics of FAs among adults.

Methods: This retrospective study included adults aged 18-80 diagnosed with FAs at the Immunology and Allergy Diseases Clinic of Ankara Bilkent City Hospital, Turkey, between 2019 and 2024.

Results: During the study period, 10,505 patients were examined to diagnose and manage various allergic and immunologic conditions. Among these, 563 patients were suspected of having FAs, which was confirmed in 33 patients (mean age 34.74 ± 12.57 years; 60.6% female), yielding a frequency of 0.31%. The primary allergens identified included hen's egg (n = 6, 18.2%), fish and shellfish (n = 4, 12.1%), and various nuts such as peanuts (n = 2, 6.1%), hazelnut (n = 1, 3.0%), and almond (n = 1, 3.0%) as well as seeds like sesame (n = 2, 6.1%) and sweet corn (n = 2, 6.1%) and fruits such as banana (n = 4, 12.1%) and kiwi (n = 4, 12.1%). The median time interval between food consumption and allergic reactions was 10 minutes (2-120). Anaphylaxis was the most frequently observed clinical presentation (n = 24, 72.7%). Emergency treatments included antihistamines and steroids (n = 15, 65.2%), antihistamines, steroids, and epinephrine (n = 5, 21.7%), or epinephrine alone (n = 3, 13.0%). Egg allergy was the most prevalent allergen (n = 6, 18.2%), characterized by a rapid onset of allergic reactions (median of 5 minutes); two patients reacted regardless of cooking methods and four showed tolerance to thoroughly cooked eggs, with component-resolved diagnostics indicating sensitization to ovalbumin (Gal d2) but not ovomucoid (Gal d1).

Conclusion: Our study demonstrates a low frequency of FAs in adults yet highlights the seriousness of reactions like anaphylaxis. Hen's egg allergy was notably prevalent, underscoring the need for increased awareness and improved diagnostic strategies to effectively manage FAs in the adult population.