Food protein–induced enterocolitis syndrome to fish and egg usually resolves by age 5 years in Spanish children

Vazquez‐Ortiz, Marta; Machinena, Adrianna; Domínguez, Olga; Alvaro, Montserrat; Calvo-Campoverde, Katty; Giner, M.T.; Jiménez‐Feijoo, Rosa; Lozano, J.J.; Piquer, M.; Dias, Marcia Tosta; Folqué, María del Mar; Plaza, Ana María

doi:10.1016/j.jaip.2016.12.029

Cited by 56 publications

(60 citation statements)

References 9 publications

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“…If no acute symptoms occurred, patients were discharged home after 4 h of observation. Finally, in 2017, Vazquez-Ortiz et al [7] administered 0.3 g/kg of the food protein (3 g as maximal dose) divided into 3 equal doses given at 90-min intervals if no reaction occurred and, in 2018, Vila Sexto [4] administered the full serving size per age divided into 5 equal doses given every 20 min followed by 4 h of observation.…”

Section: Discussionmentioning

confidence: 99%

“…The average reported age of tolerance to solid food is 42 months [6], and for fish-FPIES it is about 5 years of life [7]. …”

Section: Introductionmentioning

confidence: 99%

“…The OFC is not risk free and many patients develop severe symptoms after this procedure. There is no generally accepted protocol to perform the OFC, and several ways to do it have been described [4, 7, 8]. The International Consensus Guidelines for the Diagnosis and Management of Food Protein-Induced Enterocolitis Syndrome recommends administering the challenging food at a dose of 0.06–0.6 g, usually 0.3 g of the food protein per kilogram of body weight, in 3 equal doses over 30 min.…”

Section: Introductionmentioning

confidence: 99%

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Oral Food Challenge in Food Protein-Induced Enterocolitis Syndrome by Fish: Is There Any Room for Improvement?

Infante

Martín

Zubeldía

et al. 2019

Int Arch Allergy Immunol

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Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food hypersensitivity usually due to cow’s milk or soy. Among the solid foods, rice is one of the most causative foods worldwide, but it varies depending on the geographic area. In the Mediterranean countries, fish is one of the most important triggers of FPIES. There is not a specific biological marker for the disease that allows us to confirm the diagnosis or to predict when tolerance to the offending food has been achieved, so all patients with a FPIES diagnosis undergo an oral food challenge (OFC) at least once. The OFC is a risky procedure and many patients develop severe symptoms. Objective: We sought to evaluate the safety of a new OFC protocol in children with fish-FPIES. Methods: A retrospective study was performed over a 22-year period (1996–2018). We compared two methodologies used in the OFC: Method 1 that consisted in giving several doses during the same day versus Method 2 that consisted in giving a unique dose per day on 2 or three non-consecutive days. Results: A total of 75 positive OFC with fish done in 40 children were included. Forty-three (57.3%) OFC were performed following Method 1 and 32 (42.7%) with Method 2.The severity of the symptoms of the OFC done with Method 1 was mostly moderate (41.9%) followed by severe (39.5%) and mild (18.6%). The adverse reactions with Method 2 were mostly mild (68.8%) and only 18.8 and 12.5% presented moderate or severe symptoms, respectively. Conclusions: OFC performed in children with fish-FPIES are risky and many patients develop moderate or severe symptoms after this procedure. We propose a new protocol that has demonstrated to improve safety.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The average reported age of tolerance to solid food is 42 months [6], and for fish-FPIES it is about 5 years of life [7]. …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Oral Food Challenge in Food Protein-Induced Enterocolitis Syndrome by Fish: Is There Any Room for Improvement?

Infante

Martín

Zubeldía

et al. 2019

Int Arch Allergy Immunol

View full text Add to dashboard Cite

show abstract

“…A variety of protocols for FPIES‐related OFC have been published, differing in amount and number of doses and timing …”

Section: Resultsmentioning

confidence: 99%

“…Vazquez‐Ortiz et al administered 0.3 g of protein/kg divided into 3 equal doses at 90‐minute intervals, except for CM, in which 7 consecutive doses were given at 90‐minute intervals.…”

Section: Resultsmentioning

confidence: 99%