Morita Yoshinori
Department of Pediatrics, IMS Group, IMS Memorial Hospital, Tokyo, JPN.
Cureus. 2024 Dec 13;16(12):e75671. doi: 10.7759/cureus.75671. eCollection 2024 Dec.
Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E (IgE)-mediated food allergy. IgE sensitization to the causative food is often not observed, and the rate of sensitization to other common foods is not exceptionally high. This report discusses the case of a boy being followed up for FPIES due to egg yolk, who developed a buckwheat allergy during the disease. The boy was seen at the age of nine months because he vomited multiple times three hours after consuming egg yolk. Blood test results were IgE 32 IU/mL, egg white 3.78 UA/mL, and ovomucoid <0.1 UA/mL. The diagnosis was egg yolk FPIES, and a stepwise challenge test was performed; egg yolk FPIES was in remission by the age of three years. However, he developed hives after eating buckwheat when he was two years and two months old; a blood test was performed, which showed IgE 981 IU/mL and buckwheat >100 UA/mL. Initially, his condition was a non-IgE FPIES, showing that even if a patient does not have other IgE-mediated food allergy complications, it is possible to develop a new food allergy during the disease. This case demonstrates that in patients with FPIES, it is important to regularly evaluate blood tests and intake of typical causative foods for allergies.
食物蛋白诱导的小肠结肠炎综合征(FPIES)是一种非免疫球蛋白E(IgE)介导的食物过敏。通常观察不到对致病食物的IgE致敏情况,对其他常见食物的致敏率也并非特别高。本报告讨论了一名因蛋黄患FPIES而接受随访的男孩病例,该男孩在患病期间出现了荞麦过敏。该男孩九个月大时因食用蛋黄三小时后多次呕吐前来就诊。血液检测结果为IgE 32 IU/mL,蛋清3.78 UA/mL,类卵黏蛋白<0.1 UA/mL。诊断为蛋黄FPIES,并进行了逐步激发试验;三岁时蛋黄FPIES缓解。然而,他两岁零两个月大时吃了荞麦后出现荨麻疹;进行了血液检测,结果显示IgE 981 IU/mL,荞麦>100 UA/mL。最初,他的病情是非IgE FPIES,这表明即使患者没有其他IgE介导的食物过敏并发症,在患病期间也有可能出现新的食物过敏。该病例表明,对于FPIES患者,定期评估血液检测以及典型致病过敏食物的摄入情况很重要。