Section of Pediatric Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, Texas; Department of Pediatrics, Section of Immunology, Allergy, and Rheumatology, Texas Children's Hospital, Houston, Texas.
Section of Pediatric Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, Texas; Department of Pediatrics, Section of Immunology, Allergy, and Rheumatology, Texas Children's Hospital, Houston, Texas.
Ann Allergy Asthma Immunol. 2019 Apr;122(4):407-411. doi: 10.1016/j.anai.2019.01.022. Epub 2019 Feb 10.
Food protein-induced enterocolitis syndrome (FPIES) is an infrequent non-IgE-mediated gastrointestinal allergic disorder that occurs mostly in infants and young children. FPIES food triggers vary among different geographic locations, and the condition is still underdiagnosed and underrecognized.
To identify the triggers, characteristics, and management of FPIES in a pediatric US population of 74 children presenting to a tertiary center during a 3-year period.
We performed a retrospective electronic record review of all pediatric patients with a diagnosis of FPIES who presented to Texas Children's Hospital emergency centers and clinics.
Most of our patients were white, and 65% had a positive family history of atopy. The median age at the first FPIES episode was 5 months (interquartile range, 4-6 months), and the median age at diagnosis was 11 months (interquartile range, 7-16 months). Grains (88%), cow's milk (49%), and vegetables (43%) were the most common food triggers in our cohort. Of the fruits, banana (24%) and avocado (16%) were predominantly reported. More than half of our patients experienced FPIES to multiple food triggers.
In our cohort, rice (53%) was the most common individual food trigger, surpassing cow's milk and soybean, previously reported as the most prevalent FPIES triggers in the United States. Banana (24%) and avocado (16%) rates were also much higher than in other studied populations, likely a reflection of different dietary and weaning habits in our area. Time from disease presentation to diagnosis was delayed, potentially because of difficulties in disease recognition. We noted a significant percentage of multiple-food FPIES in contrast to other populations.
食物蛋白诱导的小肠结肠炎综合征（FPIES）是一种罕见的非 IgE 介导的胃肠道过敏疾病，主要发生在婴儿和幼儿中。FPIES 的食物触发因素因地理位置而异，且该病症仍存在漏诊和认识不足的情况。
在一家三级医疗中心的 74 名儿科患者中，确定美国儿科人群中 FPIES 的触发因素、特征和管理方法，这些患者在 3 年内就诊。
我们对所有被诊断为 FPIES 并在德克萨斯儿童医院急诊中心和诊所就诊的儿科患者进行了回顾性电子病历审查。
我们的大多数患者为白人，65%有特应性家族史。首次 FPIES 发作的中位年龄为 5 个月（四分位距，4-6 个月），诊断的中位年龄为 11 个月（四分位距，7-16 个月）。谷物（88%）、牛奶（49%）和蔬菜（43%）是本队列中最常见的食物触发因素。在水果中，香蕉（24%）和鳄梨（16%）占主要比例。我们超过一半的患者对多种食物触发因素产生 FPIES。
在我们的队列中，米饭（53%）是最常见的单一食物触发因素，超过了之前在美国报道的最常见的 FPIES 触发因素牛奶和大豆。香蕉（24%）和鳄梨（16%）的比例也远高于其他研究人群，这可能反映了我们地区不同的饮食和断奶习惯。从疾病发作到诊断的时间延迟，可能是因为疾病识别困难。我们注意到与其他人群相比，存在大量的多种食物 FPIES。
