# Pediatric Allergy to Poultry Meat: A Case of Egg-Bird Syndrome

## TL;DR

A 12-year-old boy with egg and dog allergies developed poultry meat allergy, diagnosed as egg-bird syndrome using molecular tests and treated with omalizumab.

## Contribution

Demonstrates the clinical complexity of egg-bird syndrome and the effectiveness of omalizumab in managing polysensitization.

## Key findings

- The patient's allergy to poultry meat was linked to sensitization to alpha-livetin (Gal d 5) from egg yolk.
- SDS-PAGE immunoblotting confirmed IgE reactivity to alpha-livetin and avian muscle serum albumin.
- Omalizumab treatment improved the patient's asthma and quality of life despite multiple allergies.

## Abstract

Poultry meat allergy is a rare condition that can present as a primary allergy or a secondary syndrome, such as the egg-bird syndrome. This syndrome involves primary sensitization to egg yolk (alpha-livetin (Gal d 5)) leading to cross-reactivity with poultry meat. We describe the case of a 12-year-old male patient who presented with a history of primary egg allergy and allergy to dog epithelium. He subsequently developed an allergy to poultry meat. Immunoallergological evaluation showed sensitization to egg yolk, chicken meat, and alpha-livetin (Gal d 5). Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) immunoblotting confirmed immunoglobulin E (IgE) reactivity to alpha-livetin and avian muscle serum albumin, with no cross-reactivity to dog epithelium. This confirmed the diagnosis of egg-bird syndrome. Due to severe asthma and multiple food allergies impacting his quality of life, the patient was treated with omalizumab. This case highlights the clinical complexity of the egg-bird syndrome and the utility of molecular diagnostics in differentiating cross-reactivities. Omalizumab proved effective in managing the patient's polysensitization and asthma, improving quality of life.