Test Catalog

Test Id : EGWTP

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Egg White Component Profile, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Identifying egg white allergens:

-Responsible for allergic disease and/or anaphylactic episode

-To confirm sensitization prior to beginning immunotherapy

 

This test is not useful for patients previously treated with immunotherapy to determine if residual clinical sensitivity exists, or for patients in whom the medical management does not depend upon identification of allergen specificity.

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test Id Reporting Name Available Separately Always Performed
EGG Egg White, IgE Yes Yes
OVAL Ovalbumin, IgE Yes Yes
OVMU Ovomucoid, IgE Yes Yes

Method Name
A short description of the method used to perform the test

Fluorescence Enzyme Immunoassay (FEIA)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Egg White Component Profile, S

Aliases
Lists additional common names for a test, as an aid in searching

Includes Egg White, Ovalbumin, Ovomucoid

Allergen multiple

Allergen-Specific IgE (Immunoglobulin E) Antibody Screen

Specimen Type
Describes the specimen type validated for testing

Serum

Ordering Guidance

For a listing of allergens available for testing, see Allergens - Immunoglobulin E (IgE) Antibodies

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial 

Specimen Volume: 0.75 mL; if needed, 0.5 mL for every 5 allergens requested

Collection Instructions: Centrifuge and aliquot serum into a plastic vial. 

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Forms

If not ordering electronically, complete, print, and send an Allergen Test Request (T236) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.4 mL

For 1 allergen: 0.3 mL

For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL deadspace

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
Frozen 90 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Identifying egg white allergens:

-Responsible for allergic disease and/or anaphylactic episode

-To confirm sensitization prior to beginning immunotherapy

 

This test is not useful for patients previously treated with immunotherapy to determine if residual clinical sensitivity exists, or for patients in whom the medical management does not depend upon identification of allergen specificity.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Clinical manifestations of immediate hypersensitivity (allergic) diseases are caused by the release of proinflammatory mediators (histamine, leukotrienes, and prostaglandins) from IgE-sensitized effector cells (mast cells and basophils) when cell-bound IgE antibodies interact with allergen.

 

Allergy to egg represents one of the most common causes of food allergy, especially in children. The evaluation for egg-related IgE antibodies can identify up to 95% of individuals at risk for clinical allergic reactions.

 

The most clinically prevalent allergens in egg are found in the egg white, but egg yolk also contains clinically significant specific IgE-binding allergens. The allergenic egg proteins found in egg white include ovomucoid (Gal d 1), ovalbumin (Gal d 2), ovotransferrin (Gal d 3), and lysozyme (Gal d 4). Ovomucoid has been demonstrated to be the most clinically significant egg allergen, in part due to its heat and digestion resistance. In the yolk, the protein alpha-livetin (Gal d 5) is the major allergen and is involved in bird-egg syndrome.

 

Foods that may contain egg include salad dressings, breads, breaded foods, muffins, cakes, marshmallows, prepared soups and beverages, frostings, ice cream and sherbets, pie fillings, sausages, prepared meats, mayonnaise, coatings and breading for fried foods, and some sauces.

 

Sensitization to allergic reaction to inhaled egg-white allergens has been reported in egg-processing workers and bakers.

 

Certain vaccines grown on chick embryos may cause severe allergic reactions in patients when injected. Further development of vaccines, most of which are no longer grown on egg protein, seems to have decreased or even eliminated the risk.

 

There is cross-reactivity between chicken egg white and turkey, duck, goose, and gull egg whites.

 

In vitro serum testing for IgE antibodies provides an indication of the immune response to allergens that may be associated with allergic disease.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Class

IgE kU/L

Interpretation

0 

<0.10 

Negative 

0/1 

0.10-0.34 

Borderline/equivocal 

1 

0.35-0.69 

Equivocal 

2 

0.70-3.49 

Positive 

3 

3.50-17.4 

Positive 

4 

17.5-49.9 

Strongly positive 

5 

50.0-99.9 

Strongly positive 

6 

> or =100 

Strongly positive 

 

Reference values apply to all ages.

Interpretation
Provides information to assist in interpretation of the test results

Whole egg includes proteins and potential allergens from both egg white and egg yolk. Egg white is generally more allergenic than egg yolk. Clinical reactions to egg are predominantly IgE-mediated immediate reactions characterized by atopic dermatitis, urticarial (hives), angioedema, vomiting, diarrhea, rhinoconjunctivitis, and asthma. Children with atopic dermatitis may have an immediate exacerbation of symptoms or a delayed reaction causing a worsening of their dermatitis 1 to 2 days after exposure to egg. Eosinophilic esophagitis as a result of allergy to egg has been described. Egg white is often responsible for the early development of urticaria and eczema during infancy.

 

In egg yolk, alpha-livetin (Gal d 5) is the major allergen and allergenicity to Gal d 5 is involved in bird-egg syndrome characterized egg intolerance in adults is due to sensitization by inhalation of bird dander. In these cases, there is secondary sensitization or cross-reactivity with serum albumin in egg yolk (Gal d 5) resulting in potential respiratory symptoms including asthma or rhinitis with bird exposure and additional allergic symptoms to egg.

 

Table. Major Egg Allergens

Egg white allergen

Common name

Heat-and digestion stability

Allergenic activity

Gal d 1

Ovomucoid

Stable

+++ (major allergen)

Gal d 2

Ovalbumin

Unstable

++

Gal d 3

Ovotransferrin/conalbumin

Unstable

+

Gal d 4

Lysozyme

Unstable

++

Egg yolk allergen

 

 

 

Gal d 5

Alpha-livetin, serum albumin

Partially stable

++

Gal d 6

YGP42, a lipoprotein

Stable

+

 

Detection of IgE antibodies in serum (class 1 or greater) indicates an increased likelihood of allergic disease as opposed to other etiologies and defines the allergens that may be responsible for eliciting signs and symptoms.

 

The level of IgE antibodies in serum varies directly with the concentration of IgE antibodies expressed as a class score or kU/L.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Some individuals with clinically insignificant sensitivity to allergens may have measurable levels of IgE antibodies in serum, and results must be interpreted in the clinical context.

 

False-positive results for IgE antibodies may occur in patients with markedly elevated serum IgE (>2500 kU/L) due to nonspecific binding to allergen solid phases.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Homburger HA, Hamilton RG: Allergic diseases. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. Elsevier; 2017:1057-1070

2. Caubet JC, Wang J: Current understanding of egg allergy. Pediatr Clin North Am. 2011;58(2):427-xi. doi:10.1016/j.pcl.2011.02.014

3. Shin M, Han Y, Ahn K: The influence of the time and temperature of heat treatment on the allergenicity of egg white proteins. Allergy Asthma Immunol Res. 2013 Mar;5(2):96-101. doi: 10.4168/aair.2013.5.2.96

4.Allergen Encyclopedia. ThermoFisher Scientific; 2023. Accessed February 22, 2023.Available at www.thermofisher.com/diagnostic-education/hcp/us/en/resource-center/allergen-encyclopedia.html

Method Description
Describes how the test is performed and provides a method-specific reference

Specific IgE from the patient's serum reacts with the allergen of interest, which is covalently coupled to an ImmunoCAP. After washing away nonspecific IgE, enzyme-labeled anti-IgE antibody is added to form a complex. After incubation, unbound anti-IgE is washed away, and the bound complex incubated with a developing agent. After stopping the reaction, the fluorescence of the eluate is measured. Fluorescence is proportional to the amount of specific IgE present in the patient's sample (ie, the higher the fluorescence value, the more IgE antibody is present).(Package insert: ImmunoCAP System Specific IgE FEIA. Phadia; Rev 06/2020)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

86003 x 1

86008 x 2

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
EGWTP Egg White Component Profile, S 104689-5
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
EGG Egg White, IgE 6106-9
OVAL Ovalbumin, IgE 7556-4
OVMU Ovomucoid, IgE 7557-2

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports