Factors associated with egg aversion after a negative oral food challenge result in children with egg allergies: A multicenter questionnaire survey in Japan.

Background: Many children with egg allergies experience aversion, which hinders reintroduction after a negative oral food challenge (OFC). We aimed to assess factors associated with egg aversion in children after negative egg OFCs.

Methods: We conducted a multicenter questionnaire survey between January and December 2018 and retrospectively collected background data from the medical records. Children aged 3-18 years with a history of an immediate reaction to eggs more than 6 months after a negative OFC to half of a heated whole egg were included. We defined "aversion" as a dislike of eating eggs or processed egg products.

Results: We included 140 children (median age: 6.7 years) who passed OFCs at the median age of 3.3 years and had a median specific-IgE (sIgE) to egg white of 10.0 kU/L. Overall, 57 (41 %) children had an egg aversion. "Disliking the food texture or taste" (61 %) was the most frequent reason for an aversion. The associated factor in the multivariate analysis was older age during a negative OFC (adjusted odds ratio: 1.24, 95 % confidence interval: 1.04-1.49). The aversion frequency depended on the type of cooking methods, where 68 % had an aversion to boiled egg whites, and less than 5 % had an aversion to egg-containing deep-fried chicken.

Conclusions: About half of the children after negative OFC had an egg aversion, and it was associated with older age during negative OFC. Careful follow-up and guidance with consideration of less aversive cooking methods are important in older age groups.