Food Protein-induced Enterocolitis Syndrome: A Single-center Experience

Abstract

Objective: Food protein-induced enterocolitis syndrome (FPIES) is an uncommon, non-IgE (immunoglobulin E) -mediated food allergy that mainly affects infants and young children. Our study aims to evaluate the etiology, clinical phenotypes, and tolerance status of our cases with FPIES. Method: The file records of the patients who were followed up with the diagnosis of FPIES in the Departments of Pediatric Allergy and Gastroenterology of our hospital, between September 2016 and June 2022 were examined, and families who could not attend follow-up visits regularly were contacted by phone. Results: Twelve (66.66%) of 18 cases with a mean age of admission of 33.0+-27.5 (2-108) months were boy. The triggers of FPIES were fish in 66.66%, cow's milk in 16.66%, eggs in 5.55%, eggs and milk in 5.55%, and potato in 5.55% of the patients. While 94.44% of the cases had acute FPIES, and 44.4% of them had early-onset (<9 months) FPIES. The most common symptoms were vomiting (100%), diarrhea (38.88%), pallor (27.77%), lethargy (22.22%). Food-specific IgE sensitization was found in 5.55% of the patients, while tolerance developed in 33.33% of the cases during the follow-up. The mean age of tolerance development was 63+-42 (19-112) months. Conclusion: It is important to have knowledge about the symptoms of FPIES for accurate and early diagnosis. While cow's milk is the most prevalent triggers of FPIES in the literature, fish was at the forefront in our series. Despite the limited number of cases, our results are important in terms of giving us an idea about the triggers of FPIES in the western regions of Turkey.

Keywords

• food protein-induced enterocolitis syndrome
• food allergy
• fish allergy
• children
• oral food challenge