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Test Code EGGPF Egg Comprehensive Profile, Serum


Ordering Guidance


For a listing of allergens available for testing, see Allergens - Immunoglobulin E (IgE) Antibodies



Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL; if needed, 0.5 mL for every 5 additional allergens requested

Collection Instructions: Centrifuge and aliquot serum into a plastic vial. 


Secondary ID

610705

Useful For

Identifying egg allergens:

-Responsible for allergic disease and/or anaphylactic episode

-To confirm sensitization prior to beginning immunotherapy

 

This test is not useful for patients previously treated with immunotherapy to determine if residual clinical sensitivity exists, or for patients in whom the medical management does not depend upon identification of allergen specificity.

Profile Information

Test ID Reporting Name Available Separately Always Performed
WEGG Whole Egg, IgE Yes Yes
EGG Egg White, IgE Yes Yes
YOLK Egg Yolk, IgE Yes Yes
OVAL Ovalbumin, IgE Yes Yes
OVMU Ovomucoid, IgE Yes Yes

Method Name

Fluorescence Enzyme Immunoassay (FEIA)

Reporting Name

Egg Comprehensive Profile, S

Specimen Type

Serum

Specimen Minimum Volume

0.5 mL
For 1 allergen: 0.3 mL
For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL deadspace

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  90 days

Reject Due To

Gross hemolysis OK
Thawing** Cold OK; Warm <7 days OK
Gross lipemia OK
Gross icterus OK

Clinical Information

Clinical manifestations of immediate hypersensitivity (allergic) diseases are caused by the release of proinflammatory mediators (histamine, leukotrienes, and prostaglandins) from IgE-sensitized effector cells (mast cells and basophils) when cell-bound IgE antibodies interact with allergen.

 

Allergy to egg represents one of the most common causes of food allergy, especially in children. The evaluation for egg-related IgE antibodies can identify up to 95% of individuals at risk for clinical allergic reactions.

 

The most clinically prevalent allergens in egg are found in the egg white, but egg yolk also contains clinically significant specific IgE-binding allergens. The allergenic egg proteins found in egg white include ovomucoid (Gal d 1), ovalbumin (Gal d 2), ovotransferrin (Gal d 3) and lysozyme (Gal d 4). Ovomucoid has been demonstrated to be the most clinically significant egg allergen, in part due to its heat and digestion resistance. In the yolk, the protein alpha-livetin (Gal d 5) is the major allergen and is involved in bird-egg syndrome.

 

Foods that may contain egg include salad dressings, breads, breaded foods, muffins, cakes, marshmallows, prepared soups and beverages, frostings, ice cream and sherbets, pie fillings, sausages, prepared meats, mayonnaise, coatings and breading for fried foods, and some sauces.

 

Sensitization to allergic reaction to inhaled egg-white allergens has been reported in egg-processing workers and bakers.

 

Certain vaccines grown on chick embryos may cause severe allergic reactions in patients when injected. Further development of vaccines, most of which are no longer grown on egg protein, seems to have decreased or even eliminated the risk.

 

There is cross-reactivity between chicken egg white and turkey, duck, goose, and gull egg whites.

 

In vitro serum testing for IgE antibodies provides an indication of the immune response to allergens that may be associated with allergic disease.

 

Reference Values

Class

IgE kU/L

Interpretation

0

<0.10

Negative

0/1

0.10-0.34

Borderline/Equivocal

1

0.35-0.69

Equivocal

2

0.70-3.49

Positive

3

3.50-17.4

Positive

4

17.5-49.9

Strongly positive

5

50.0-99.9

Strongly positive

6

≥100

Strongly positive

 

Reference values apply to all ages.

Interpretation

Whole egg includes proteins and potential allergens from both egg white and egg yolk. Egg white is generally more allergenic than egg yolk. Clinical reactions to egg are predominantly IgE-mediated immediate reactions characterized by atopic dermatitis, urticarial (hives), angioedema, vomiting, diarrhea, rhinoconjunctivitis, and asthma. Children with atopic dermatitis may have an immediate exacerbation of symptoms or a delayed reaction causing a worsening of their dermatitis 1 to 2 days after exposure to egg. Eosinophilic esophagitis as a result of allergy to egg has been described. Egg white is often responsible for the early development of urticaria and eczema during infancy.

 

In egg yolk, alpha-livetin (Gal d 5) is the major allergen and allergenicity to Gal d 5 is involved in bird-egg syndrome characterized egg intolerance in adults is due to sensitization by inhalation of bird dander. In these cases, there is secondary sensitization or cross-reactivity with serum albumin in egg yolk (Gal d 5) resulting in potential respiratory symptoms, including asthma or rhinitis with bird exposure and additional allergic symptoms to egg.

 

Table. Major Egg Allergens

Egg white allergen

Common name

Heat-and digestion stability

Allergenic activity

Gal d 1

Ovomucoid

Stable

+++ (major allergen)

Gal d 2

Ovalbumin

Unstable

++

Gal d 3

Ovotransferrin/conalbumin

Unstable

+

Gal d 4

Lysozyme

Unstable

++

Egg yolk allergen

 

 

 

Gal d 5

Alpha-livetin, serum albumin

Partially stable

++

Gal d 6

YGP42, a lipoprotein

Stable

+

 

Detection of IgE antibodies in serum (Class 1 or greater) indicates an increased likelihood of allergic disease as opposed to other etiologies and defines the allergens that may be responsible for eliciting signs and symptoms.

 

The level of IgE antibodies in serum varies directly with the concentration of IgE antibodies expressed as a class score or kU/L.

Cautions

Some individuals with clinically insignificant sensitivity to allergens may have measurable levels of IgE antibodies in serum, and results must be interpreted in the clinical context.

 

False-positive results for IgE antibodies may occur in patients with markedly elevated serum IgE (>2500 kU/L) due to nonspecific binding to allergen solid phases.

Clinical Reference

1. Homburger HA, Hamilton RG: Allergic diseases. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. Elsevier; 2017:1057-1070

2. Caubet JC, Wang J: Current understanding of egg allergy. Pediatr Clin North Am. 2011;58(2):427-xi. doi: 10.1016/j.pcl.2011.02.014

3. Shin M, Han Y, Ahn K: The influence of the time and temperature of heat treatment on the allergenicity of egg white proteins. Allergy Asthma Immunol Res. 2013 Mar;5(2):96-101. doi: 10.4168/aair.2013.5.2.96

4.Allergen Encyclopedia. ThermoFisher Scientific; 2023. Accessed February 22, 2023. Available at www.thermofisher.com/diagnostic-education/hcp/us/en/resource-center/allergen-encyclopedia.html

Method Description

Specific IgE from the patient's serum reacts with the allergen of interest, which is covalently coupled to an ImmunoCAP. After washing away nonspecific IgE, enzyme-labeled anti-IgE antibody is added to form a complex. After incubation, unbound anti-IgE is washed away, and the bound complex is then incubated with a developing agent. After stopping the reaction, the fluorescence of the eluate is measured. Fluorescence is proportional to the amount of specific IgE present in the patient's sample (ie, the higher the fluorescence value, the more IgE antibody is present).(Package insert: ImmunoCAP System Specific IgE FEIA; Phadia; Rev 06/2020)

Day(s) Performed

Monday through Friday

Report Available

Same day/1 to 3 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

86003 x 3

86008 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
EGGPF Egg Comprehensive Profile, S 104536-8

 

Result ID Test Result Name Result LOINC Value
EGG Egg White, IgE 6106-9
YOLK Egg Yolk, IgE 6107-7
OVAL Ovalbumin, IgE 7556-4
OVMU Ovomucoid, IgE 7557-2
WEGG Whole Egg, IgE 7291-8

Forms

If not ordering electronically, complete, print, and send an Allergen Test Request (T236) with the specimen.