From the Department of Pediatric Allergy, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Allergy Asthma Proc. 2020 Nov 1;41(6):420-427. doi: 10.2500/aap.2020.41.200078.
Food protein-induced enterocolitis syndrome (FPIES) is a rare non-IgE mediated food allergy. To delineate the differences in the spectrum of culprit foods, remission patterns, and predictors among varying cultures. We reviewed demographics, culprit foods, outcomes, and predictors in 81 children with a diagnosis of FPIES who were followed up between 2015 and 2020. Eighty-one patients (55.6% boys) were enrolled, including 72 with acute FPIES and 9 with chronic FPIES. Hen's egg was the most common culprit food (36.6%), followed by fish (26.9%), and cow's milk (21.5%). Interestingly, cow's milk was significantly prevalent in chronic FPIES cases (p = 0.006). The most common clinical symptoms were vomiting (100%), pallor (63.4%), and lethargy (55.9%). Emergency department visits were noted in 39 patients (41.9%), of whom 37 (39.8%) were treated with intravenous (IV) fluid. The subjects were followed up for a median (interquartile range) of 19.4 months (12.3-41.2 months), and 26 subjects (32.1%) achieved tolerance. The median (interquartile range) age at tolerance was 2.5 years (2.1-3.2 years). With regard to the culprit foods, hen's egg was observed more frequently in the subjects with resolved FPIES cases (p = 0.008), whereas fish FPIES cases were high in the persistent group (p = 0.001). IgE sensitization of the culprit food was found to be an independent risk factor for the persistence of FPIES (odds ratio 4.855 [95% confidence interval, 1.131-20.844]; p = 0.034). In our cohort, unlike other published series, hen's egg and fish were the two most common culprit foods. Fish differed from other culprit foods, with significantly delayed onset and persistence, and may create a model that allows for the understanding of the disease.
食物蛋白诱导的小肠结肠炎综合征（FPIES）是一种罕见的非 IgE 介导的食物过敏。为了描绘不同文化之间罪魁祸首食物的范围、缓解模式和预测因素的差异。我们回顾了 2015 年至 2020 年间 81 名 FPIES 患儿的人口统计学、罪魁祸首食物、结局和预测因素。81 例患儿（55.6%为男性）入组，其中 72 例为急性 FPIES，9 例为慢性 FPIES。鸡蛋是最常见的罪魁祸首食物（36.6%），其次是鱼（26.9%）和牛奶（21.5%）。有趣的是，牛奶在慢性 FPIES 病例中明显更为常见（p=0.006）。最常见的临床症状是呕吐（100%）、苍白（63.4%）和嗜睡（55.9%）。39 例患儿（41.9%）就诊于急诊，其中 37 例（39.8%）接受静脉（IV）补液治疗。中位（四分位距）随访时间为 19.4 个月（12.3-41.2 个月），26 例（32.1%）患儿达到耐受。中位（四分位距）耐受年龄为 2.5 岁（2.1-3.2 岁）。就罪魁祸首食物而言，鸡蛋在已缓解的 FPIES 病例中更为常见（p=0.008），而鱼类 FPIES 病例在持续组中更为常见（p=0.001）。罪魁祸首食物的 IgE 致敏被认为是 FPIES 持续存在的独立危险因素（比值比 4.855[95%置信区间，1.131-20.844]；p=0.034）。在我们的队列中，与其他已发表的系列不同，鸡蛋和鱼是两种最常见的罪魁祸首食物。与其他罪魁祸首食物不同，鱼类的发病时间和持续时间明显延迟，可能形成一种模式，有助于理解这种疾病。
