Paediatric Allergy Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.
Pediatr Allergy Immunol. 2021 Apr;32(3):560-565. doi: 10.1111/pai.13430. Epub 2021 Jan 11.
Fish is the most common causative food of food protein-induced enterocolitis syndrome (FPIES) in Southern Europe. In children with FPIES, the development of tolerance varies according to the culprit food and specifically fish seems to have a poorer prognosis than other solid foods. We sought to evaluate the fish-FPIES resolution rate in children.
A descriptive retrospective analysis of children with fish-FPIES, followed during the last 20 years, was performed. The offending fish, age and symptoms at onset, the coexistence of atopic diseases and FPIES to other foods were registered. All the children included had undergone an oral food challenge (OFC) with the offending fish. We recorded those children that overcame their fish-FPIES and those that did not outgrow the disease.
Seventy children were enrolled in this study (median age: 9 yo; IQR 6.4-13.8). Forty-two (60%) achieved tolerance to the offending fish with a median age of 4 years (IQR: 3-5). Among children ≤5 yo (n = 40), 35 (87.5%) developed tolerance; among 6-8yo (n = 14), 40% developed tolerance; and only 12.5% among those ≥9 yo (n = 16) developed tolerance. Twenty-eight children did not outgrow the disease (median age: 8.9 yo; IQR: 9-13.8). We did not find any statistical differences regarding the offending fish, presence of single vs multiple fish-FPIES, symptoms at the beginning, coexistence of other atopic diseases or the coexistence of other FPIES, between the children who overcame the disease and those who did not.
One in five children with FPIES to fish will not overcome the disease during childhood.
鱼类是南欧食物蛋白诱导性肠炎综合征（FPIES）最常见的致病食物。在患有 FPIES 的儿童中，对食物的耐受性各不相同，具体来说，鱼类似乎比其他固体食物的预后更差。我们试图评估儿童对鱼类 FPIES 的缓解率。
对过去 20 年来接受随访的鱼类 FPIES 患儿进行描述性回顾性分析。记录了致病鱼、发病时的年龄和症状、特应性疾病的共存以及对其他食物的 FPIES 等信息。所有纳入的患儿均进行了口服食物激发试验（OFC）以确定其对致病鱼的反应。我们记录了那些克服了鱼类 FPIES 的患儿和那些未缓解的患儿。
本研究共纳入 70 例患儿（中位年龄：9 岁；IQR 6.4-13.8）。42 例（60%）对致病鱼产生了耐受性，中位年龄为 4 岁（IQR：3-5）。在≤5 岁的患儿（n=40）中，35 例（87.5%）产生了耐受性；6-8 岁的患儿（n=14）中，40%产生了耐受性；而≥9 岁的患儿（n=16）中，仅 12.5%产生了耐受性。28 例患儿未缓解（中位年龄：8.9 岁；IQR：9-13.8）。在缓解疾病和未缓解疾病的患儿之间，我们未发现与致病鱼、单一或多种鱼类 FPIES 的存在、发病时的症状、其他特应性疾病的共存或其他 FPIES 的共存有关的任何统计学差异。
在患有鱼类 FPIES 的儿童中，每五分之一的患儿在儿童时期不会缓解疾病。
