Practical issues of oral immunotherapy in egg or milk allergy.

Oral immunotherapy (OIT) has been recommended to reduce parental burden related to strict allergen avoidance as well as to induce desensitization and immune tolerance for patients with long-lasting allergies to hen's eggs (HE) or cow's milk (CM). OIT should be monitored by pediatric allergists specializing in OIT and oral food challenge tests to cope with allergic reactions. Although a previous history of anaphylaxis or multiple food allergy is not a contraindication to OIT, it is absolutely contraindicated if the patient has uncontrolled asthma, malignancy, active systemic autoimmune disorders, or diseases requiring treatment with beta-blockers. A variety of OIT protocols have been developed for better outcomes and safe up-dosing including adjunctive therapies with biologics. This review provides insights into the practical issues of various immunotherapy options in children with HE or CM allergies.