The Role of Baked Egg and Milk in the Diets of Allergic Children. Fecha: Lunes 1 de octubre de 2018
The Role of Baked Egg and Milk in the Diets of Allergic Children
Authors:
Robinson ML, Department of Pediatrics, National Jewish Health, 1400 Jackson Street, K830, Denver, CO 80206, USA; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: Robinsonm2@njhealth.org.
Lanser BJ, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA; Department of Pediatrics, Division of Allergy and Clinical Immunology, National Jewish Health, 1400 Jackson Street, J322, Denver, CO 80206, USA.
Abstract:
Baked egg and baked milk are tolerated by most children who are allergic to hen's egg and cow's milk. Incorporating baked goods into the diets of allergic children may help them outgrow their primary allergy more quickly, with changes observed akin to immunotherapy. Benefits may also include increased quality of life and improved nutritional status. The search for a reliable biomarker to predict tolerance to bakedgoods is ongoing. Most children with a milk or egg allergy who are not previously tolerating egg or milk in baked goods should be offered an observed oral food challenge.
Baked egg and baked milk are tolerated by most children who are allergic to hen's egg and cow's milk. Incorporating baked goods into the diets of allergic children may help them outgrow their primary allergy more quickly, with changes observed akin to immunotherapy. Benefits may also include increased quality of life and improved nutritional status. The search for a reliable biomarker to predict tolerance to bakedgoods is ongoing. Most children with a milk or egg allergy who are not previously tolerating egg or milk in baked goods should be offered an observed oral food challenge.
Asistentes: Ricardo Cardona Villa, Carlos Chinchilla, Ana Maria Calle, Luis Carlos Santamaria, July Ospina, Yurlani Gutierrez, Susana Uribe.
ResponderEliminar• Se destaca la importancia no solo de la temperatura sino también de la matriz con trigo, donde el gluten es importante e indispensable y conlleva a un cambio conformacional de las proteínas, logrando evadir la unión de IgE específica dirigida a las proteínas de huevo y leche de vaca.
• Se debe buscar siempre, que se cumplan las condiciones de temperatura y concentración de las proteínas para los retos con huevo y leche, incluso prefiriendo las formas industrializadas que garantizan un procesamiento estandarizado.
• Aún no existen marcadores para predecir la tolerancia al huevo o leche horneados.
• Una tasa de 31% de reacciones en pruebas de provocación con productos horneados con huevo y 35% con leche es un valor considerable, por lo que consideramos que estos retos deben ser realizados siempre bajo supervisión médica.
• Aún con el reto negativo con productos horneados, se debe tener en cuenta que se pueden presentar reacciones en casa y el paciente debe continuar portando adrenalina y debe tener información clara sobre las matrices y formas de cocción.
• Sería ideal tener valores de referencia de nuestra población (Colombia) para establecer los valores predictivos pre-prueba para los retos con productos horneados con leche y huevo.