Alergia a las proteínas del huevo en edad pediátrica

Marco Antonio Góngora-Meléndez, Armando Magaña-Cobos, Juan Manuel Montiel-Herrera, Cinthya Lorena Pantoja-Minguela, Mario Luis Pineda-Maldonado, Eduardo Enrique Piñeyro-Beltrán

Resumen


La prevalencia de alergia alimentaria se incrementó en los últimos años: afecta de 15 a 20% de la población infantil; específicamente, la alergia al huevo afecta de 0.5 a 2% de población pediátrica. La mayor parte de las reacciones alérgicas al huevo son tipo I; es decir, son mediadas por anticuerpos de tipo IgE dirigidos contra proteínas contenidas en este alimento. Se ha identificado cinco alergenos mayores: ovomucoide (Gal d1), ovoalbúmina (Gal d2), ovotransferrina (Gal d3), lisozima (Gal d4) y albúmina (Gal d5). La mayor concentración de proteínas alergénicas están en la clara del huevo (Gal d1-4), mientras que en la yema de huevo sólo encontramos una (Gal d5). La proteína ovomucoide, que contiene la clara, es resistente al calor y a las enzimas digestivas; se considera la proteína con mayor poder alergénico y la ovoalbúmina es la proteína más abundante. El diagnóstico clínico requiere una detallada anamnesis. Por lo general, se realiza cualquiera de las pruebas (cutáneas o IgE específica) como primera opción. Las pruebas cutáneas son una prueba rápida y útil para determinar la existencia de anticuerpos IgE específicos al huevo. La IgE específica al huevo puede medirse cuantitativamente mediante estudios estandarizados de IgE in vitro. En conjunto con una buena historia clínica, se utilizan para apoyar el diagnóstico clínico. El reto oral estandarizado, doble ciego, controlado con placebo, aún es el patrón de referencia para el diagnóstico de alergia alimentaria. La identificación y eliminación en la dieta de la proteína de huevo responsable de las reacciones alérgicas es el tratamiento primario y el único validado contra la alergia a este alimento, pero se necesitan más estudios para establecer los protocolos para cada alergeno específico del huevo, antes de que la inmunoterapia oral se convierta en una práctica rutinaria.


Palabras clave


alergia al huevo; inmunoterapia oral; alergia alimentaria

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Referencias


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DOI: http://dx.doi.org/10.29262/ram.v62i3.86

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