Study Shows Children with Private Insurance More Likely to Outgrow Food Allergies

Newswise — ANAHEIM, Calif. (Nov. 9, 2023) – Some children will outgrow a food allergy, but how this happens is not well understood. A new study being presented at this year’s American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting in Anaheim, Calif. shows that children with private insurance are more likely to outgrow food allergies than children who use public insurance.

“We reviewed a cohort of food allergy patients enrolled in the FORWARD (Food Allergy Management and Outcomes Related to Racial/Ethnic Differences from Infancy through Adolescence) study to try to determine which had outgrown their food allergies,” said allergist Arabelle Abellard, MD, MSc., ACAAI member and lead author on the study. “Milk and egg allergy were the most frequently outgrown allergies. And children with public insurance (12%) compared to children with private insurance (29%) were significantly less likely to report outgrowing food allergy.”

The cohort at the study site included 188 children consisting of 62% male, 51% Black, 32% White and 16% Latinx participants. 21% of the children outgrew at least one food allergy, with a total of 72 food allergies outgrown. The mean age at which food was outgrown was 5 years. The foods that were most frequently outgrown were milk followed by egg, then tree nuts, soy and peanut.

“This study provides additional information to our growing body of research on how and why children outgrow food allergies, specifically studying, for the first time, children from various racial groups,” says allergist Amal Assa'ad, MD, ACAAI member and co-author of the study. “As food allergies cause social, emotional and physical burdens on children and their families, food allergy researchers seek data to assist in our search for cures.”

An additional study being presented – a medically challenging case titled, “Successful Egg Reintroduction in Adolescent Patient with Recalcitrant Egg Allergy” shows the importance of baked egg oral food challenges in adolescent patients who previously had anaphylaxis to egg products. In the case, a 15-year-old patient came to an allergy clinic with a diagnosis of multiple food allergies, including severe anaphylactic reactions to scrambled eggs. One year later, the clinic performed skin testing and the results were not clear regarding the severity of her egg allergy. Because of the vague results, an oral food challenge was attempted, and she was able to tolerate baked egg muffins. She can now eat eggs in baked form which has improved her quality of life significantly despite past elevation in blood tests and recent anaphylaxis.

The authors note that increasing exposure to baked eggs in patients with a history of anaphylaxis to eggs, and continued re-evaluation of adolescents with egg allergies is helpful. This case demonstrates the importance of baked egg oral food challenges in adolescent patients who previously had anaphylaxis to egg products even as recently as one year prior.

Abstract Title: Development of Tolerance In Children with Food Allergy  

Presenter: Arabelle Abellard, MD, MSc

Medically Challenging Case Abstract Title: Successful Egg Reintroduction in Adolescent Patient with Recalcitrant Egg Allergy

Presenter: Lily Tran, BS

For more information about food allergies and anaphylaxis, or to find an allergist in your area, visit AllergyandAsthmaRelief.org. The ACAAI Annual Scientific Meeting is Nov. 9-13. For more news and research from the ACAAI Scientific Meeting, go to our newsroom and follow the conversation on X/Twitter #ACAAI23.

About ACAAI

The American College of Allergy, Asthma & Immunology (ACAAI) is a professional medical organization of more than 6,000 allergists-immunologists and allied health professionals, headquartered in Arlington Heights, Ill. Founded in 1942, the College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy, and research. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer immunotherapy, and provide patients with the best treatment outcomes. For more information and to find relief, visit AllergyandAsthmaRelief.org. Join us on Facebook, Pinterest, Instagram and X/Twitter.

P189 DEVELOPMENT OF TOLERANCE IN CHILDREN WITH FOOD ALLERGY S. Alabduljabbar¹, L. Bilaver¹, A. Assa'ad², C. Warren¹, J. Jiang¹, R. Gupta¹, M. Mahdavinia¹, 1. Chicago, IL; 2. Cincinnati, OH.

Introduction: Despite the rising prevalence of food allergy (FA), some children outgrow their food allergies. However, factors associated with the development of clinical tolerance are not understood. We aim to investigate a prospective cohort of children with FA at our institution, a site of the FORWARD (Food Allergy Management and Outcomes Related to Racial/Ethnic Differences from infancy through Adolescence) study to answer this question. Methods: The study included Black, White and Latinx children aged 0 to 12 years with IgE-mediated, physician-diagnosed FA. Participants were surveyed about outgrowing any food allergies with specific questions. Results: The cohort at this site included 188 children consisting of 62% male, 51% Black, 32% White and 16% Latinx participants. 39 (21%) children outgrew at least one food allergy, with a total of 72 food allergies outgrown. Mean age at which food was outgrown was 5.31 years (SD=3.50). The foods that were most frequently outgrown were milk followed by egg, then tree nuts, soy and peanut. Insurance coverage was associated with outgrowing food allergy; 9 (12%) publicly insured children outgrew foods, compared to 26 (29%) privately insured children. Mean age of development of FA among those who developed tolerance was (M=3.19 years, SD=2.70), which was significantly less than the mean age of development of FA among those who never developed tolerance (M=4.30 years, SD=3.61), t=1.72, p=.043. Conclusion: Milk and egg allergy were the most frequently outgrown allergies. Children with public insurance compared to children with private insurance were significantly less likely to report outgrowing food allergy.

Comparison of Subjects with and without Development of Food Tolerance

M325

SUCCESSFUL EGG REINTRODUCTION IN ADOLESCENT PATIENT WITH RECALCITRANT EGG ALLERGY L. Tran^*1, M. Dickinson Matson¹, C. Enweasor², G. Odudu³, 1. Redlands, CA; 2. Sacramento, CA; 3. Loma Linda, CA.

Introduction: Egg allergy is a common food allergy in the pediatric population, affecting 0.5-2.5% of young children. Recent studies have shown that early introduction can decrease the development of food allergies in young children; however, research for reintroduction in older children is lacking. We report a case of egg reintroduction in an adolescent with a severe allergy to eggs.

Case Description: A 15-year-old patient presented to the allergy clinic with a diagnosis of multiple food allergies, including severe anaphylactic reactions to scrambled eggs. Skin testing one year after recent anaphylaxis was equivocal with wheals of 0 mm to egg white and 6 mm to egg yolk. Given these results, an oral food challenge was attempted, and she was able to tolerate baked egg muffins. She can now eat eggs in baked form which has improved her quality of life significantly despite past elevation in blood tests and recent anaphylaxis.

Discussion: Despite recent anaphylaxis to cooked eggs, a 15-year-old patient tolerated baked eggs in an oral food challenge 1 year after her initial reaction. Food allergy management tends to be static and limiting, especially in older pediatric patients. Additionally, egg tolerance rates have been decreasing. Therefore, increasing exposure to baked eggs in patients with a history of anaphylaxis to eggs and continual re-evaluation of adolescents with egg allergies are quintessential. This case demonstrates the importance of baked egg oral food challenges in adolescent patients who previously had anaphylaxis to egg products even as recently as 1 year.