What is an egg allergy?
Egg allergies among the most common IgE-mediated food allergies in children. Fortunately, the majority of children with egg allergy will outgrow it.
Children who are allergic to eggs typically display symptoms within minutes to hours of eating eggs or foods containing eggs. Symptoms can range from mild to severe and may include difficulty breathing, nausea, hives and more rarely, anaphylaxis, a life-threatening allergic response.
Causes of egg allergies
Egg allergies happen when the body misidentifies the proteins in egg whites and/or egg yolks as something harmful. The body defends itself by releasing histamine, a chemical that causes symptoms such as coughing, wheezing and hives.
Signs and symptoms of egg allergies
If your child is allergic to egg, it may cause symptoms in multiple areas of the body, including:
- Skin: hives (red, blotchy skin that can itch) and may include mild to severe swelling
- Lungs: difficulty breathing, shortness of breath, coughing or wheezing
- Eyes: itching, tearing or redness
- Throat: tightness, trouble breathing or inhaling
- Stomach: repeated vomiting, nausea, abdominal pain and cramping or diarrhea
- Nose: congestion, copious clear discharge, sneezing or itching
- Neurologic: change in behavior or mood, dizziness
- Drop in Blood Pressure: This is the most dangerous symptom of a severe allergic reaction
If your child experiences any of these symptoms after eating eggs, call your pediatrician and arrange to have your child tested by a pediatric allergist.
If a child has any two systems involved from the above list, this means they may be experiencing anaphylaxis.
If your child has symptoms of anaphylaxis, call 911 immediately.
Testing and diagnosis of egg allergy
If you suspect your child is allergic to eggs, clinicians at Children’s Hospital of Philadelphia will take a detailed medical history including information on prior food reactions. Based on your child’s history and findings, our clinicians may order one or more of the following tests:
In allergy skin testing, a very small amount of the food allergen is introduced to the skin, typically, on your child’s forearm — through a gentle pinprick. The appearance of a hive-like bump may indicate an egg allergy.
In allergen-specific IgE blood tests, a small amount of your child's blood is drawn and tested for antibodies the child may have produced in response to exposure to an allergen.
A food challenge test involves giving your child a small increasing amount of egg in a controlled, highly supervised clinical setting to monitor for any reactions.
Treatments for egg allergy
Once our clinicians confirm your child has an egg allergy, the first step in treatment is avoiding eggs and food products that contain eggs. While eliminating egg dishes from your child’s diet may sound relatively straightforward, eggs are a hidden ingredient in many foods, including baked goods, salad dressing, ice cream and meatballs. Even egg substitutes may potentially contain egg protein. It is important to read labels carefully.
Your child’s doctor can give you detailed information on how to read food labels to help you and your child identify and avoid egg protein.
No matter how careful you are, there may be times when your child accidentally eats eggs and has a reaction. When that happens, you can treat the symptoms with antihistamines or epinephrine.
If more than one body system is involved in the allergic reaction — for example the skin and lungs — it is recommended to use epinephrine. Epinephrine comes in a variety of forms, including auto-injectors such as Epi-Pen, Auvi-Q and other generic forms.
If your child’s reaction is mild and only involves a few hives, an over-the-counter or prescription strength antihistamine may ease their symptoms. Your child’s doctor can help you decide which option is best for your child in specific circumstances.
Children with allergies to eggs should carry epinephrine with them, or it should be readily available at places where they routinely spend time, such as school, daycare and home.
When to call 911
If your child has a severe reaction or signs of anaphylaxis, administer epinephrine and then call 911 right away. In some circumstances, children may need more than one dose of epinephrine, so it is important to have medical assistance in these situations if needed.
Oral immunotherapy (OIT), may help desensitize your child to eggs. Your child will ingest small quantities of egg protein in a controlled setting to monitor for reactions, then continue that amount of egg protein every day at home. The amount of egg protein will be gradually increased under close medical supervision at the hospital. Your allergy provider can help you determine if oral immunotherapy may be appropriate for your child. If so, you'll receive a referral to CHOP’s Oral Immunotherapy Program.
Follow-up care for egg allergies
Most of the ongoing treatment for allergies can be done at home. Once your child has been diagnosed with an egg allergy, you and your family will be given more information on how to avoid exposure to eggs and treat any reactions you child may experience.
You may also want to let your extended family, close friends and your child’s school know about the egg allergy so they can help reduce the chance of accidental exposure outside your home.
Many children will outgrow their egg allergy. Your child should undergo a supervised test, such as a food challenge to determine whether it’s safe to begin incorporating eggs into their diet.
Outlook for children with egg allergies
It’s getting easier to accommodate children with egg allergies. Manufacturers are required to label foods that contain potential allergens, such as eggs.