Posted: 04.20.2010 at 12:01:32
There hasn't been (up until VERY recently) a lot of research in this area.
My allergist has hinted that he feels that "tolerance" of cooked food may not lead to true NORMAL tolerance of the food in general. That it truly isn't the same thing as a cure, at least for most kids who would otherwise remain allergic.
This was re: our conversation with him about the possibility of pursuing desensitization for egg with our DD. He had at one time been quite keen to try this with DD... and now he strongly discouraged us from doing it and emphatically said that he would not be a part of it.
On the other hand, for kids who are destined to outgrow ANYWAY, it seems to help. Does it accelerate the process? Slow it down? Who knows. But it sure improves quality of life in the meantime, since accidental exposures become so much less problematic.
Trouble, it seems to me, is that there isn't currently any great way of knowing who is who there.
That is, by late adolescence, it is still true that ~80-90% of allergic children are outgrowing milk/egg.
But that still means that there is a cohort of 10-20% that aren't ever going to. Desensitizing that group makes some sense, since you aren't really "altering" the natural course of events any.
On the flip side of that, though, I'm not sure that there is much evidence either way regarding complete avoidance, either. That is, is it helpful? (Probably not, if the population stats are anything to go by, right? I mean, if thirty years ago, 90% of these kids outgrew by SCHOOL age, and now ~85% of them are outgrowing by COLLEGE age... that's not a change for the better. Avoidance has become much better as education of parents and food labeling has improved, one would imagine.)
On the other hand, it's hard to tease that apart from the overall rise in atopic conditions over the same time period. So an egg allergy in a preschooler born in 1980 is probably not the same allergy as for a preschooler born in 2000.
There are studies underway-- but the results might not be known for years. There may be some teasers from this year's AAAAI meeting.
I'd look and see if there are any abstracts on the subject.
Home Introduction of Baked Milk in Children with a History
of Milk Allergy
K. E. Mudd, S. K. Driggers, E. C. Matsui, R. A. Wood;
Johns Hopkins University, School of Medicine, Baltimore, MD.
and the companion poster:
Home Introduction of Baked Egg in Children with a History of
S. K. Driggers, K. E. Mudd, E. C. Matsui, R. A. Wood;
Johns Hopkins University, Baltimore, MD.
Office Based Oral Desensitization of Patients With Anaphylactic
Sensitivity to Foods Is Safe and Effective
R. L. Wasserman1, L. E. Mansfield2, A. R. Gallucci1, H. R. Hutteman2,
A. M. Ruvalcaba2, N. A. Long1, D. M. Pence1;
1DallasAllergyImmunology, Dallas, TX, 2Allergy Asthma
Immunology El Paso, El Paso, TX.
The complete list of scientific abstracts is here:http://www.jacionline.org/webfiles/images/journals/ymai/Scientific_Program_239-288.pdf
And once you find an abstract you are interested in, note which session it is in, and what number it is-- then you can look it up by day and session:http://www.jacionline.org/content/2010_annual_meeting
"To travel hopefully is a better thing than to arrive." -Robert Louis Stevenson