Hospital Universitario Central de Asturias, Oviedo.
Hospital Infantil Virgen del Rocío, Sevilla.
J Pediatr Gastroenterol Nutr. 2019 Feb;68(2):232-236. doi: 10.1097/MPG.0000000000002169.
The aim of the study was to describe clinical, epidemiological, and management characteristics of food protein-induced enterocolitis syndrome (FPIES) cases in Spain.
Multicenter observational retrospective study. FPIES cases diagnosed in specialized units in Spain over 12 months in 2017 (January-December) according to the recently published international diagnostic criteria were included.
One hundred twenty patients (53.3% boys) were included. The majority were acute cases (111) with mild-to-moderate severity (76.7%). Triggering foods were cow's milk (48/120), fish (38), egg (13), rice (12), and soy (1). The majority (84.2%) of the patients had FPIES to 1 food only. In addition to vomiting (100%), pallor (89.2%), and altered behavior (88.3%) were most frequently observed in acute forms. On the contrary, diarrhea (70%), abdominal distension (33.3%), and blood in stools (44.4%) were more frequently observed in chronic cases. Oral challenge was performed in 18.9% of the acute forms compared to 44.4% of the chronic forms. The most common treatment was intravenous fluids followed by ondansetron. Corticosteroids were used in 6 patients (5 with acute symptoms and 1 chronic). Seven patients were treated with antibiotics for suspicion of infection. Most cases of cow's milk FPIES were treated with extensively hydrolyzed formulas (69.8%).
FPIES is not uncommon in our units. Unlike other published series, fish and egg are important triggers in our country. A greater knowledge and diffusion of the international consensus criteria will allow a better characterization of the cases and a standardization of their management.
本研究旨在描述西班牙食物蛋白诱导性肠炎综合征（FPIES）病例的临床、流行病学和管理特征。
这是一项多中心观察性回顾性研究。纳入了 2017 年（1 月至 12 月）在西班牙专门单位根据最近发布的国际诊断标准诊断的 FPIES 病例，共 120 例患者（53.3%为男性）。
大多数患者为急性病例（111 例），病情较轻至中度（76.7%）。触发食物为牛奶（48/120）、鱼（38）、蛋（13）、大米（12）和大豆（1）。大多数患者（84.2%）仅对 1 种食物发生 FPIES。除呕吐（100%）外，急性患者中苍白（89.2%）和行为改变（88.3%）最常见；而慢性患者中腹泻（70%）、腹胀（33.3%）和粪便带血（44.4%）更常见。在急性病例中，有 18.9%进行了口服激发试验，而慢性病例中有 44.4%进行了该试验。最常见的治疗方法是静脉补液，其次是昂丹司琼。皮质类固醇仅用于 6 例患者（5 例为急性症状，1 例为慢性）。7 例患者因疑似感染而使用抗生素治疗。大多数牛奶 FPIES 病例采用深度水解配方治疗（69.8%）。
在我们的单位中，FPIES 并不少见。与其他已发表的系列研究不同，鱼类和蛋类是我们国家的重要触发因素。更深入地了解和传播国际共识标准将有助于更好地描述病例并标准化其管理。
