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The aim of this study was to define levels of egg white- and yolk-specific IgE antibodies that would confirm the diagnosis of egg allergy with a positive predictive value (PPV) of 100%. The study was carried out on 185 children with suspected food allergy recruited consecutively at the Children’s Hospital. One group included 100 children with a positive hen’s egg oral food challenge (OFC) test. They were compared with 85 children with peanut allergy but not egg allergy (negative egg OFC). We analyzed the children’s clinical symptoms, family history of atopic diseases, skin prick test results (SPT) with raw egg white and yolk, serum samples for specific IgE antibodies to egg white and yolk using the Pharmacia Cap system FEIA method, open controlled challenge tests with whole raw egg or double-blind controlled food challenges with peanut. Median age was 2.1 years (range 0.8–15 years). The median skin reaction to the egg extract was 11.3 mm (range 0–25 mm) in the first group and 5.5 mm in the second (P = 0.00001). We found a higher level of egg white-specific IgE antibodies in the egg allergy group (22.5 vs. 0.76 kUA/l, P = 0.000001) and also a higher level of yolk-specific IgE antibodies (6 vs. 0.35 kUA/l, P = 0.0001). For the egg white antibodies, a threshold value equal to or greater than 7.5 kUA/l resulted in a PPV of 100% and a negative predictive value (NPV) of 68%. For the yolk-specific antibodies, a threshold value equal to or greater than 5.5 kUA/l resulted in a PPV of 100% and a NPV of 52%.Conclusion. – Our study demonstrated better sensitivity for egg white-specific IgE antibodies and better specificity for egg yolk-specific IgE antibodies. Both measurements are useful for the diagnosis of egg allergy in children. In addition, with an egg white-specific IgE antibody level equal to or greater than 7.5 kUA/l and a yolk-specific IgE antibody level equal to or greater than 5.5 kUA/l, the patient can be said to be egg-allergic with nearly 100% certainty. [Copyright &y& Elsevier]

A benchmark study was conducted in the southwest of France, in the New Aquitaine region, to investigate metabolic outcomes and availability of resources in pediatric diabetes units. We assessed whether the level of care was in accordance with the International Society for Pediatric and Adolescent Diabetes recommendations. Demographic and clinical data were collected, as were all HbA1c tests for the 2017 calendar year. Pediatricians specialized in diabetes care were invited to complete an online survey concerning means allocated to the management of type 1 diabetes in their centers. Sixteen centers provided data for 1277 patients and 3873 clinical visits. A total of 1115 children suffering from diabetes for more than 1 year were studied. Median HbA1c was 8% (7.4–8.6) for the whole region. Only 29.2% of children had good metabolic control in accordance with the < 7.5% target. We identified slight but significant variation in glycemic control among centers (P = 0.029). The use of an insulin pump varied greatly among centers but did not explain HbA1c differences. We did not identify a correlation between medical or paramedical time dedicated to the follow-up of diabetic patients and the mean HbA1c of each center. For 100 diabetic patients, follow-up was provided by 0.42 physicians (0.23–1.50), 0.15 nurses (0–0.56), 0.12 dietitians (0–0.48), and 0.07 psychologists (0–0.30). This study demonstrates a lack of human resources allocated to the management of type 1 diabetes in the region that is far below international recommendations. The proportion of children achieving the international glycemic target is low. There is a clear need to improve glycemic control in children, which will only be possible with improved professional practices, encouraged by benchmark studies, and by increasing the size of our multidisciplinary teams. [ABSTRACT FROM AUTHOR]