Fecha de publicación: -- Fuente: PubMed "meat" Pediatr Allergy Immunol. 2026 Nov;37(11):e70532. doi: 10.1111/pai.70532.ABSTRACTBACKGROUND: The clinical significance of Gal d 5 (α-livetin), the serum albumin of egg yolk (EY), is established in adult bird-egg syndrome but poorly defined in children. We investigated Gal d 5-associated clinical phenotypes and the diagnostic performance of Gal d 5-specific IgE for EY allergy.METHODS: We retrospectively reviewed 1400 children who underwent ALEX2 multiplex testing between January 2020 and March 2026. Eighty-nine with Gal d 5-specific IgE ≥0.10 kUA/L were included. EY allergy and reactions following bird/poultry exposure or contact with or consumption of poultry meat were characterized. ROC analyses and logistic regression evaluated Gal d 5-specific IgE and conventional allergy tests.RESULTS: Of 89 Gal d 5-sensitized children, 14 (15.7%) had clinically relevant EY allergy and 75 (84.3%) were sensitized-tolerant. Bird/poultry exposure reactions (6.7%) and poultry meat consumption reactions (3.4%) were uncommon. EY allergy was associated with higher Gal d 5 multiplex-specific IgE (mlt-sIgE), EY singleplex-specific IgE (sng-sIgE), and EY mlt-sIgE. EY mlt-sIgE had the highest numerical AUC (0.822), followed by EY sng-sIgE (0.797), without significant pairwise differences among egg-directed measures. Gal d 5 mlt-sIgE showed moderate diagnostic performance (AUC 0.741; Youden-derived cut-off 4.36 kUA/L) and was associated with EY allergy (OR 1.18, 95% CI 1.05-1.33).CONCLUSIONS: Most Gal d 5-sensitized children tolerate EY and rarely exhibit bird- or poultry-related reactions. Higher Gal d 5 mlt-sIgE levels were associated with a greater likelihood of EY allergy, but their diagnostic utility was moderate and should be interpreted alongside clinical history and conventional allergy tests.PMID:43001561 | DOI:10.1111/pai.70532