Egg Allergies -Causes, Signs and symptoms

Egg Allergies

Also called: Egg Sensitivity

Summary

Egg allergies are a common type of food allergy that occurs in people sensitive to one or more components of eggs. In such people an allergic reaction occurs after coming into contact with eggs (usually by eating them), resulting in allergy symptoms such as itchiness, rash, hives, stomach cramps, nausea and respiratory problems. Most people with egg allergies are allergic to most types of eggs, including chicken eggs, duck eggs and quail eggs. Occasionally, a person is allergic only to chicken eggs.

Egg allergies, like many food allergies, are rare. Most occur in young children and infants, and they are usually outgrown by the age of 5 or 6. The most effective treatment for individuals suffering from egg allergies is the complete removal of eggs (including egg products and derivatives) from the diet.

Sticking to an egg–free diet can be complicated due to the large number of foods that use eggs as an ingredient. These include baked goods, pastas, sauces, salad dressings, drinks and desserts. Further complicating the issue, whole eggs are not the only form of eggs used as an ingredient.

There are a number of egg proteins that are used in foods and will not be listed as “eggs” on food labels. Instead, they are listed by the protein name, such as albumin, globulin and livetin. Individuals with egg allergies must be sure to learn the names of egg proteins and avoid eating products containing them. Allergic individuals should also avoid inhaling the gases produced by eggs when being cooked. These gases and fumes can trigger symptoms associated with allergic rhinitis (hay fever).

Treatment of the symptoms associated with egg allergies usually involves the use of medications, such as antihistamines and bronchodilators. Individuals who are susceptible to the most severe and potentially deadly allergic reaction known as anaphylaxis are often advised by their physician to carry an epinephrine shot. Epinephrine helps to reverse the severe breathing problems associated with anaphylaxis.

Some people who react to eggs suffer not from a food allergy but from food intolerance. This condition is more common and usually less severe, although the symptoms often closely resemble those of a food allergy.

Intolerance occurs when the body is unable to digest a type of food or a component of food. It is not an allergic reaction because it does not involve the immune system. An allergy occurs when the body mistakenly believes a substance (usually a protein) is harmful, causing the immune system to overreact. As with egg allergies, treatment of egg intolerance often involves the elimination of eggs from the diet.

About egg allergies

An egg allergy is a common type of food allergy that occurs when a person’s immune system overreacts following exposure to eggs or egg derivatives (egg whites, egg yolks or egg proteins).

Eggs are one of the six foods that account for 90 percent of food-related allergic reactions in children, according to the American Academy of Allergy, Asthma and Immunology (AAAAI). Egg allergies typically begin in infancy, and most children who develop an early egg allergy will outgrow the condition by the age of 5 or 6.

Food allergies themselves are rare, occurring in about 6 to 8 percent of children and about 2 percent of adults. Susceptible children or adults who have been exposed to an egg allergen, usually by eating it, will typically display symptoms within a few minutes to a few hours. Symptoms frequently include itchiness, rashes, hives, stomach cramps, nausea and breathing problems. Severe reactions to eggs may result in a potentially life–threatening condition known as anaphylactic shock.

Egg allergies occur when an egg component triggers an allergic response. The immune system mistakes the egg for a harmful substance and releases antibodies called immunoglobulin E (IgE) in response. As a defense against the invader, the IgE antibodies cause certain histamines to be released into the blood stream. These histamines result in the unpleasant allergic symptoms most people associate with egg allergies.

Egg and egg derivatives are found in a broad variety of substances, and only a trace amount of egg is needed to trigger an allergic attack in some individuals. Sensitive individuals need to be aware of the many types and names of egg products and egg derivatives.

In some instances a person can be allergic to the gases given off by eggs during cooking. This condition usually triggers cases of allergic rhinitis (hay fever), the inflammation of mucous membranes lining the nose after an allergic reaction. Symptoms associated with this condition include runny nose, stuffy head, nasal congestion and sinus pressure.

While most people are allergic to the whites of eggs, a few rare people find they are allergic to proteins found in the yolk. These individuals will experience an allergic reaction to both egg yolks and inhaled or ingested bird antigens (usually from feather particles, dried airborne droppings and meat). This condition is known as bird-egg syndrome.

Some individuals find they are only seasonally allergic to eggs. This usually occurs in people who have allergies to oak pollen, short and western ragweed, and the goosefoot family of weeds. When these allergens are in season, some people may find they also have a cross-reaction with eggs. This occurs because the proteins in the airborne allergens are similar enough to those in eggs that the body confuses the two.

Potential causes of egg allergies

While some people are allergic only to chicken eggs, most people are allergic to eggs from any fowl, including chickens, ducks and quail. Egg allergies are caused by the immune system’s reactions to eggs, egg products or egg derivatives, usually when these items are ingested. These can be found in a whole host of foods, including (but not limited to):

  • Baby food

  • Baked goods and baking mixes (e.g., breads, rolls, cakes, cookies, crackers, doughnuts, pretzels, pancakes)

  • Pastas (e.g., spaghetti, vermicelli, penne, egg noodles)

  • Sauces and salad dressings (e.g., Caesar dressing, mayonnaise, béarnaise sauce, hollandaise sauce, tarter sauce)

  • Drinks (e.g., root beer, coffee, beer, wine)

  • Desserts (e.g., fudge, ice cream, sherbet, pudding, some chocolate, cream pies, cream puffs, frosting, marshmallows, meringue)

  • Breaded or battered fried foods (e.g., chicken nuggets, meatballs, meat loaf, sausage)

  • Soups (e.g., noodle soups, consommé, egg drop soup)

In addition, some brands of egg substitute actually contain egg whites. To find out if a food contains eggs, egg products or egg derivatives, individuals should always check the ingredient label. To avoid eating a product that contains eggs, individuals should stay away from products that contain:

  • Egg white and egg white solids
  • Egg yolk
  • Egg solids
  • Powdered egg
  • Whole egg

An egg derivative (e.g., an egg protein) present in a food can be just as dangerous as egg itself to people with egg allergies. In these cases, the name “egg” may not specifically appear anywhere on the ingredient label. Some of the many types of egg derivatives and extracts that allergic individuals should stay away from include:

  • Albumin
  • Apovitellenin
  • Globulin
  • Livetin
  • Lysozyme
  • Ovalbumin
  • Ovoglobulin
  • Ovomucin
  • Ovomucoid
  • Ovotransferrin
  • Ovovitella
  • Ovovitellin
  • Phosvitin
  • Silici albuminate
  • Simplesse
  • Vitellin

As a general rule, terms containing “ovo” or “albumin” typically signal the presence of egg. Additionally, the substance lecithin is often made with egg yolks. People with concerns over food products containing lecithin can contact the manufacturer to better determine its source.

Since food manufacturers change the ingredients in their products from time-to-time, it is important for people with egg allergies to read product labels each time they shop. Individuals with egg allergies should also be aware that some cosmetics and shampoos also contain egg proteins.

It was once commonly believed that people with egg allergies could not receive the measles–mumps–rubella (MMR) vaccine, which is produced using cells from chicken eggs. Experts now believe the vaccine can be safely administered to people with egg allergies. However, a skin test may still be recommended before the vaccine is given in some cases.

Influenza vaccines are grown on egg embryos. As a result, they may contain a trace amount of egg protein. People with egg allergies should speak with their physician before receiving these vaccinations.

Related allergies and conditions

There are several factors that may predispose a young child towards an egg allergy. When their families have a history of allergic rhinitis (hay fever), asthma, hives or eczema, it typically increases the likelihood that a child will develop one or more food allergies. Many types of food allergies, however, including egg allergies, gradually go away as children grow and their digestive and immune systems mature.

When the gases or fumes from eggs are inhaled (for instance, during cooking) allergic rhinitis can result. This kind of reaction typically has symptoms associated with the inhalation of dusts or pollens, which cause the mucous membranes lining the nose to become inflamed. Symptoms associated with this condition include runny nose, stuffy head, nasal congestion and sinus pressure.  

In addition, several related conditions may be mistaken for a food allergy. These include:

  • Food intolerances. These conditions usually involve the body’s inability to break down specific food substances (such as egg proteins), rather than an allergic response to the food in question. They are often confused with food allergies because symptoms, causes and treatments may be similar. However, food intolerances are more common and usually less severe.

  • Irritable bowel syndrome. A disorder in which the large intestine (colon) does not function normally, leading to cramping, abdominal pain, bloating, constipation and/or diarrhea. Because specific types of food will sometimes trigger irritable bowel symptoms, this condition may be confused with an egg allergy.

  • Other gastrointestinal conditions. Some kinds of cancers and ulcers of the gastrointestinal tract can produce symptoms similar to those experienced with egg allergies. These symptoms can include vomiting, diarrhea or cramping abdominal pain that gets worse when eating.

  • Food poisoning. A reaction to bacteria, chemicals or other toxins found in contaminated or spoiled foods. Symptoms may be similar to those of an egg allergy.

  • Stress or psychological issues. While the relationship between stress and allergy symptoms is not entirely clear, some individuals will feel sick simply by thinking about a certain type of food.

Signs and symptoms of egg allergies

Exposure to eggs can trigger a whole host of allergic responses in sensitive individuals. These symptoms typically appear within minutes of eating an egg or egg derivative, though some reactions are known to occur up to several hours later. Symptoms of an egg allergy typically include:

  • Skin conditions, such as itchiness, rashes, hives or red bumps.
  • Gastrointestinal conditions, such as stomach cramps, diarrhea, nausea or vomiting.

  • Respiratory conditions, such as wheezing or coughing.

  • Nasal or sinus conditions, such as runny nose or sneezing. Symptoms of allergic rhinitis are more common when fumes from eggs are inhaled during cooking, rather than when eggs are ingested.

The most sensitive individuals may experience a potentially life-threatening condition called anaphylactic shock, which usually involves the constriction of the air passageways and a dangerous drop in blood pressure. Individuals who exhibit symptoms involving two or more body systems (anaphylaxis) should seek immediate medical help. Symptoms of anaphylactic shock include:

  • Shortness of breath
  • Tightening in the chest or throat
  • Choking
  • Loss of consciousness

Diagnosis methods for egg allergies

The methods used to diagnosis egg allergies are very similar to those used in other food allergies. It can be relatively simple to diagnose an egg allergy when eggs are already a suspected allergen trigger. However, most people with egg allergies react to egg proteins within other foods. As a result, diagnosis may be more complicated.

In order to diagnose egg allergies, a physician will perform a physical exam and collect the patient’s medical history. The most basic question a physician will ask is whether an individual has a consistent reaction to eggs each time they are consumed. Other questions may focus on frequency of reaction, timing of symptoms after eating a particular food and family history of allergies and other conditions (e.g., asthma, eczema).

To be sure that eggs are the culprit, a physician will often administer one or more of the following tests:

  • Skin test. During these tests, egg extracts are introduced to a portion of the skin through a scratch, prick, injection or patch The appearance of redness or swelling in the test area indicates an allergic response.. This test can be too dangerous to use on highly sensitive individuals.

  • RAST (radioallergosorbent test). This type of blood test allows a laboratory to directly test a blood sample from an individual in an attempt to detect antibodies that correspond to an egg allergy. This test can be used on those people who have reactions that are too sensitive for a skin test. The RAST test is also a good option for infants, or individuals with skin disorders such as eczema.

  • Elimination diet. This test involves removing eggs from an individual’s diet for several weeks to see if allergic reactions persist. If the reactions do indeed stop, it can be presumed that eggs were the culprit.

  • Oral food challenge. This is considered the most effective way of determining the cause of a food allergy because it supplies the most convincing results. Different foods are placed within capsules to hide their identity. The patient consumes the capsules and the physician looks for signs of an allergic reaction. This type of test is time-consuming and difficult. It is often reserved to confirm suspicions that a patient’s symptoms are not caused by a food allergy.

Treatment options for egg allergies

It is not possible to prevent an allergic reaction to eggs. Instead, treatments are aimed at relieving allergy-related symptoms. 

Like other food allergies, allergic reactions to eggs usually result in symptoms that affect the nose, throat, lungs, skin and gastrointestinal tract. These symptoms can be treated with several types of medications, including:

  • Antihistamines. Medications that provide relief for more basic allergy symptoms such as hives, sneezing, runny nose and gastrointestinal conditions. Antihistamines directly counteract the effects of the histamines, which are responsible for most egg allergy symptoms. With mild symptoms, these drugs are usually administered orally. For more severe allergic reactions, a physician may recommend an injected form of antihistamine.

  • Bronchodilators. Medications that open the airways of the lungs, relieving symptoms such as shortness of breath or wheezing. They may be recommended for people whose egg allergies trigger asthma attacks or asthma-like symptoms. They are usually breathed directly into the lungs using an inhaler.

  • Epinephrine injection. A synthetic form of adrenaline that, when injected, is a powerful bronchodilator, opening breathing tubes and restoring normal respiration quickly. It is usually reserved for the most severe allergic reactions that involve anaphylaxis. Most physicians recommend that individuals who are susceptible to severe egg reactions carry an injection of epinephrine with them at all times and understand how to self–administer the drug. A medical alert bracelet or necklace is also a good idea for these individuals.

  • Corticosteroids. Medications that reduce inflammation. These medications are most commonly used to treat severe allergic reactions in infants.

Most young children or infants who develop an allergy to eggs will outgrow the condition by the age of 5 or 6. This is thought to be a result of the immune system gradually maturing as the child grows older. Some individuals with egg allergies maintain the condition throughout their adult lives, however.

Prevention methods for egg allergies

Like all food allergies, the most effective way of treating an egg allergy is to eliminate the problem food completely from the diet. Individuals who have an allergic reaction to eggs should never eat eggs, egg products or egg derivatives unless their physician has specifically told them otherwise.

An allergic reaction can be triggered by only a trace amount of egg or egg extract. People should also avoid inhaling the gases and fumes produced by cooking eggs, as well as any direct skin contact. While maintaining an egg–free diet can be difficult due to the large number of foods that contain eggs and egg derivatives, this kind of diet is an essential treatment for people with egg allergies.

Egg–sensitive individuals also need to become familiar with the many types of egg derivatives commonly found in today’s foods. Extracts such as albumin, globulin and livetin can be just as dangerous as plain eggs and should be avoided with equal care.

By checking ingredient lists for eggs and egg derivatives, and inquiring about ingredients and cooking techniques at restaurants, an individual can limit their exposure to dangerous egg allergens.

New legislation may make it easier for people to determine if a food item contains a potential allergen. As of January 2006, food manufacturers are required by the Food & Drug Administration (FDA) to clearly list food allergens on their product labels.

Since an infant or young child is often too young to make dietary or medical decisions, the parents or guardian must take responsibility for keeping the child’s diet egg–free. Parents should also let their child’s school cafeteria or daycare facilities know about any special dietary needs.

Individuals must also learn what steps to take if they do come into contact with an allergen. Physicians often recommend that the most sensitive individuals carry an epinephrine shot to counteract the affects of the potentially life-threatening condition known as anaphylactic shock. These individuals should know how to correctly self-administer their medication and parents should know how to properly treat a severe reaction in their child.

While there are no alternate foods that can replicate the taste of eggs, there are some alternatives that can duplicate its cooking qualities. Egg–free cookie recipes often substitute a mixture of vegetable oil, baking powder and water for the egg. Commercial egg substitutes and egg white substitutes are also popular alternatives. However, it is important to note that some brands of egg substitutes contain egg whites. In some cases, an allergic reaction can be avoided by substituting the eggs of other birds (most often ducks or quail) for the chicken’s eggs. Before attempting this switch, however, an allergic individual should consult their physician.

Because different people with egg allergies will respond with different levels of severity, some people are able to tolerate exposure to small amounts of egg. Some individuals may also be more sensitive to different types of egg exposure. For example, egg whites often cause a more severe allergic reaction than the yolks, due to the concentration of protein in that part of the egg. However, all parts of an egg, as well as its derivatives, should always be avoided unless an individual’s physician has determined otherwise.

Questions for your doctor

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctors the following questions related to egg allergies:

  1. Do my symptoms indicate an egg allergy?

  2. What tests will you use to determine if I am allergic to eggs?

  3. Does my egg allergy pose a danger to my overall health?

  4. Am I allergic to all types of eggs or just chicken eggs?

  5. What are my treatment options? Will I require an allergy kit?

  6. What types of food/ingredients should I avoid?

  7. Is it safe for me to occasionally eat a small amount of egg, egg product or egg derivative?

  8. Is it safe for me to prepare eggs for someone else?

  9. What should I do if I accidentally ingest an egg product?

  10. Are my children likely to develop this condition as well?

  11. Will my child outgrow this allergy?
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