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\begin{document}

\title{Follow-up of hen's egg allergic children: investigation of factors that
influence the reevaluation of tolerance development}



\author[1]{Kirsten BEYER}%
\author[1]{Paul Baek}%
\author[1]{Josefine Dobbertin-Welsch}%
\author[1]{Birgit Kalb}%
\author[1]{Valérie Trendelenburg}%
\author[1]{Sebastian  Tschirner}%
\author[1]{Meike Veit}%
\author[1]{Songül Yürek}%
\affil[1]{Charite Universitatsmedizin Berlin - Campus Virchow-Klinikum}%


\vspace{-1em}



  
  \date{June 14, 2024}


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\begin{abstract}
\textbf{Background:} In order to determine tolerance development in
hen's egg (HE) allergic children, international guidelines recommend an
oral food challenge after 6-24 months. This study aimed to assess
whether parents follow this advice and factors that influence their
decision. \textbf{Methods:} A follow-up of 158 challenge-proven HE
allergic children was performed. Families who did not come to a
rechallenge were contacted by phone and a standardized survey relating
to the current allergy status was conducted. Logistic regression models
were used to assess the effect of clinical and laboratory
characteristics on the reevaluation of the allergy status.
\textbf{Results:} 35\% of the HE-allergic children conducted a
rechallenge in a hospital, 27\% continued avoiding HE without
reevaluation and 11\% performed a ``home-testing'' with HE. The odds
ratio for patients to test for HE tolerance at home instead of in a
hospital increased 7.94 times (CI:2.31-27.31) for every decrease in the
severity score at the initial challenge, and 3.24 times (CI:1.26-8.33)
for every decrease of the baseline specific IgE CAP-class. Tolerance of
heated HE prior to reevaluation was most frequent in the home-tested
(100\%) and was more frequent in patients, who continued avoidance
(68\%) compared to those, who were rechallenged (44\%).
\textbf{Conclusions:} Our data suggest an association between reaction
severity as well as specific IgE levels at initial food challenge and
the choice of families whether and how to evaluate natural tolerance
development in their HE-allergic child. Individualized management may be
needed in order to achieve safe and effective medical care for these
patients.%
\end{abstract}%



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Title Page

1. Full title of manuscript:

Follow-up of hen's egg allergic children: investigation of factors that
influence the reevaluation of tolerance development

\textbf{2. Authors:}

Baek, Paul Sunwoo; Dobbertin-Welsh, Josefine; Y\selectlanguage{ngerman}ürek, Songül; Tschirner,
Sebastian; Veit, Meike; Kalb, Birgit, MD; Trendelenburg, Valérie, PhD;
Beyer, Kirsten, MD

\textbf{3. Authors' institutional affiliations:}

Charité Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute
of Health; Department of Pediatric Respiratory Medicine, Immunology and
Critical Care Medicine; Berlin; Germany

\textbf{4. Running title}

Hen's egg allergy reevaluation

\textbf{5. Corresponding author:}

Prof. Dr. med. Kirsten Beyer

Charité Universitätsmedizin Berlin,

Department of Pediatric Respiratory Medicine, Immunology and Critical
Care Medicine Augustenburger Platz 1,

D-13353 Berlin, Germany

Phone: +49-(0)30-450 559054; FAX: +49-(0)30-450559951

E-Mail: kirsten.beyer@charite.de

\textbf{6. Word count:} 2488 \textbf{; Tables:} 2\textbf{; Figures:} 4

\textbf{7. Material in the electronic repository:} none

\textbf{Hosted file}

\verb`Baek-Main Text.docx`  available at \url{https://authorea.com/users/333894/articles/560213-follow-up-of-hen-s-egg-allergic-children-investigation-of-factors-that-influence-the-reevaluation-of-tolerance-development}\selectlanguage{english}
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