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Vol. 45. Issue 4.
Pages 393-404 (July - August 2017)
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Vol. 45. Issue 4.
Pages 393-404 (July - August 2017)
DOI: 10.1016/j.aller.2017.05.001
Oral immunotherapy for food allergy: A Spanish guideline. Immunotherapy egg and milk Spanish guide (items guide). Part I: Cow milk and egg oral immunotherapy: Introduction, methodology, rationale, current state, indications contraindications and oral immunotherapy build-up phase
A. Martorella,
Corresponding author

Corresponding author.
, E. Alonsob, L. Echeverríac, C. Escuderod, R. García-Rodrígueze, C. Blascof, J. Boneg, J. Borja-Segadee, T. Bracamontec, A. Claverh, J.L. Corzoi, B. De la Hozj, R. Del Olmok, O. Dominguezl, V. Fuentes-Apariciom, I. Guallarg, H. Larramonan, F. Martín-Muñozo, V. Matheup, A. Michavilaq, I. Ojedar, P. Ojedar, M. Piquerl, P. Pozap, M. Reches, P. Rodríguez del Ríod, M. Rodríguezt, F. Ruanou, S. Sánchez-Garcíad, S. Terradosv, L. Valdesoiron, M. Vazquez-Ortizw, Expert panel selected from members of the Spanish Societies of Pediatric Allergology, Asthma and Clinical Immunology (SEICAP) and Allergology and Clinical Immunology (SEAIC)
a Department of Allergology, University General Hospital, Valencia, Spain
b Department of Pediatric Allergy, Gregorio Marañón Hospital, Madrid, Spain
c Department of Pediatric Allergy, Severo Ochoa University Hospital, Leganés, Spain
d Department of Pediatric Allergy, Niño Jesús University Children's Hospital, Madrid, Spain
e Department of Allergology, University General Hospital, Ciudad Real, Spain
f Department of Pediatric Allergy, Vall d’Hebron Hospital, Barcelona, Spain
g Department of Pediatric Allergy, Miguel Servet University Hospital, Zaragoza, Spain
h Quirón Dexeus University Hospital, Barcelona, Spain
i Department of Pediatric Allergy, Carlos Haya University Hospital, Málaga, Spain
j Department of Allergology, Ramón y Cajal Hospital, Madrid, Spain
k Department of Pediatric Allergy, University Hospital, Móstoles, Spain
l Department of Pediatric Allergy, San Joan de Deu Hospital, Barcelona, Spain
m Department of Allergology, San Carlos Clinic Hospital, Madrid, Spain
n Department of Pediatric Allergy, Parc Taulí University Hospital, Sabadell, Spain
o Department of Allergology, La Paz Children's Hospital, Madrid, Spain
p Allergology Unit-North Chest Hospital, Santa Cruz de Tenerife, Spain
q Department of Pediatric Allergy, General Hospital, Castellón, Spain
r Ojeda Clinic, Madrid, Spain
s Department of Allergology, Infanta Sofía Hospital, San Sebastián de los Reyes, Spain
t Department of Allergology, Alcorcón Foundation Hospital, Alcorcón, Spain
u Department of Allergy, Infanta Leonor Hospital, Madrid, Spain
v Department of Pediatric Allergy, Ramón y Cajal Hospital, Madrid, Spain
w Pediatric Allergy, Department of Medicine, Imperial College London, United Kingdom
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Tables (1)
Table 1. Advantages and inconveniences of the different raw egg-white products in OIT.
Additional material (2)

Cow's milk and egg are the most frequent causes of food allergy in the first years of life. Treatments such as oral immunotherapy (OIT) have been investigated as an alternative to avoidance diets. No clinical practice guides on the management of OIT with milk and egg are currently available.


To develop a clinical guide on OIT based on the available scientific evidence and the opinions of experts.


A review was made of studies published in the period between 1984 and June 2016, Doctoral Theses published in Spain, and summaries of communications at congresses (SEAIC, SEICAP, EAACI, AAAAI), with evaluation of the opinion consensus established by a group of experts pertaining to the scientific societies SEICAP and SEAIC.


Recommendations have been established regarding the indications, requirements and practical aspects of the different phases of OIT, as well as special protocols for patients at high risk of suffering adverse reactions.


A clinical practice guide is presented for the management of OIT with milk and egg, based on the opinion consensus of Spanish experts.

Oral immunotherapy
Specific oral tolerance induction
Milk allergy
Egg allergy
Sublingual immunotherapy


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