Use of an egg ladder for home egg introduction in children with IgE‐mediated egg allergy

Thomas, Leah; Belcher, Jan; Phillips, Rachael; Preece, Kahn; Bhatia, Rani

doi:10.1111/pai.13541

Cited by 13 publications

(14 citation statements)

References 9 publications

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“…Similarly, with the use of an egg ladder among low‐risk patients, only 2 (4.3%) patients had a severe reaction, with one requiring epinephrine. Importantly, both children were eventually able to progress successfully 17 …”

Section: Safety Concerns Of Food Allergen Laddersmentioning

confidence: 94%

“…Importantly, both children were eventually able to progress successfully. 17 While these studies demonstrate the safety among patients with IgE-mediated allergy, children with non-IgE-mediated allergy may also present with non-immediate gastrointestinal symptoms or eczema flares as well.…”

Section: Safe T Y Con Cern S Of Food Allerg En L Adder Smentioning

confidence: 98%

“…Similarly, a recent Australian article reported safe and successful implementation of home-based egg ladders in patients with IgE-mediated egg allergy. 17 Patient satisfaction was high with nearly 80% of parents reporting being satisfied or very satisfied with this approach with taste and texture reported as potential limitations. Reactions were mostly mild, and 1 dose of epinephrine was administered.…”

Section: Clini C Al Us E Of Food Allerg En L Adder Smentioning

confidence: 99%

“…34 The updated IMAP recipes also consider that children may spend many months consuming the foods indicated in the ladder. Thomas et al 17 indicated that children spent on average 15.5 months on the ladder.…”

Section: B Enefits and Con Cern S Of Us Ing Food Allerg En L Adder Smentioning

confidence: 99%

“…The BSACI original egg ladder 16 and their recently updated ladder 15 consists of a number of main stages with many smaller steps, similar to the BSACI milk ladder. Thomas et al 17 published an egg ladder based on typical Australian food. The ladder includes six steps, and recipes are provided, but the amount of egg, timing of cooking, or temperature were not indicated as families individualized the portions offered.…”

Section: Currently Available Ladders For Ige‐ and Non‐ige‐mediated Fo...mentioning

confidence: 99%

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Food allergen ladders: A need for standardization

Venter

Ebisawa

Athanasopoulou

et al. 2021

Pediatric Allergy Immunology

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Introduction:The process of gradually reintroducing food allergens into an individual's diet is referred to as food allergen "ladders". There remain many questions regarding the foods chosen, structure and composition of the ladder, and medical and safety considerations. The COVID-19 pandemic has propelled us into an era where medicine is increasingly practiced via online platforms, highlighting the need for standardized food allergen ladder approaches for successful and safe introduction of food allergens. Methods:We performed a search of currently published food allergen ladders and obtained published information and clinical expertise to summarize current knowledge and suggest future standardized approaches for using food allergen ladders.Results: There are currently a limited number of published milk, egg, wheat, and soy ladders. We suggest the following points should be considered when developing food ladders: (1) Food allergen: dose, time, and temperature of heating of the food allergen, simplicity of the ladder and recipes, the possible role of the wheat matrix, and testing for allergenic protein levels to standardize doses; (2) Nutritional factors: health and nutritional value of the foods in the ladder, taste, texture, and cultural appropriateness of foods should be considered; and (3) Medical aspects: consideration of which patients are safe to undergo ladders outside of the clinical setting, other safety aspects and risk factors for severe reactions, number of days suggested per steps, and availability and provision of rescue medication. Written instructions and recipes should be provided to families who wish to use food allergen ladders.Discussion: Food allergen ladders used for gradual reintroduction of food allergens into a food allergic individual's diet are increasingly being used internationally.Standardization regarding the foods included in the ladder and medical considerations are required to practice patient-centered care, best assist patients and families, and ensure safety.

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Section: Safety Concerns Of Food Allergen Laddersmentioning

confidence: 94%

Section: Safe T Y Con Cern S Of Food Allerg En L Adder Smentioning

confidence: 98%

Section: Clini C Al Us E Of Food Allerg En L Adder Smentioning

confidence: 99%

Section: B Enefits and Con Cern S Of Us Ing Food Allerg En L Adder Smentioning

confidence: 99%