Egg and milk allergy in adults. Diagnosis and characterization

Allergy. 1992 Oct;47(5):503-9. doi: 10.1111/j.1398-9995.1992.tb00673.x.


Nineteen adult patients representing a total of 24 medical histories of immediate adverse reactions to egg or cows' milk underwent 1) standardized questioning about signs/symptoms occurring less than 2 h after ingestion of egg or milk, 2) skin prick test, RAST and histamine release test, and 3) titrated, oral, double-blind, placebo-controlled challenge (DBPCFC) with fresh egg or milk. Eleven medical histories (46%) were confirmed by DBPCFC in 10 patients (53%). All DBPCFC-positive patients experienced gastrointestinal symptoms, and in 80% of the patients, gastrointestinal symptoms were accompanied by respiratory or skin symptoms. Threshold doses varied between 50 mg and 250 g, with 4 patients presenting objective signs following 5 g or less. DBPCFC-positive patients reported significantly more symptoms and had a significantly higher number of positive tests than had DBPCFC-negative patients. None of the tests were in significant concordance with DBPCFC, although RAST showed a sensitivity of 100%. Thus, DBPCFC cannot be substituted in the diagnosis of milk and egg allergy in adults. The use of titrated, fresh foods in DBPCFC proved to be a safe and well-controlled procedure.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Double-Blind Method
  • Eggs / adverse effects*
  • Female
  • Food Hypersensitivity / diagnosis*
  • Food Hypersensitivity / immunology
  • Food Hypersensitivity / physiopathology
  • Histamine Release
  • Humans
  • Immunoglobulin E / analysis
  • Male
  • Milk Hypersensitivity / diagnosis*
  • Milk Hypersensitivity / immunology
  • Milk Hypersensitivity / physiopathology
  • Radioallergosorbent Test
  • Sensitivity and Specificity


  • Immunoglobulin E