Food protein–induced enterocolitis-like syndrome in a population of adolescents and adults caused by seafood

González-Delgado, Purificación; Caparrós, Esther; Moreno, María Ángeles Esteban; Cueva, Begoña; Fernández, J.

doi:10.1016/j.jaip.2018.07.028

Cited by 55 publications

(72 citation statements)

References 9 publications

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“…The dramatic symptoms of acute FPIES are usually triggered by shellfish and fish, whereas more chronic gastrointestinal symptoms have been attributed to CM, wheat/gluten and hen's egg. While the prevalence and natural history of adult FPIES remain unknown, the recent report from Spain provided interesting insights . Twenty‐five patients with exclusively gastrointestinal symptoms following ingestion of seafood and negative skin and food‐specific IgE were reported.…”

Section: Different Phenotypes Of Food Protein‐induced Enterocolitis Smentioning

confidence: 99%

“…Food protein-induced enterocolitis syndrome in adults has been reported anecdotally for many years; however, only recently adult case series have been published in the peer-reviewed literature. [31][32][33][34][35] The dramatic symptoms of acute FPIES are usually triggered by shellfish and fish, whereas more chronic gastrointestinal symptoms have been attributed to CM, wheat/gluten and hen's egg. While the prevalence and natural history of adult FPIES remain unknown, the recent report from Spain provided interesting insights.…”

Section: Adult Food Protein-induced Enterocolitis Syndromementioning

confidence: 99%

“…While the prevalence and natural history of adult FPIES remain unknown, the recent report from Spain provided interesting insights. 35 Twenty-five patients with exclusively gastrointestinal symptoms following ingestion of seafood and negative skin and food-specific IgE were reported. Delay to diagnosis was median 8 years, median number of past episodes was 8, highlighting the under-recognition of this disorder in the adult population.…”

Section: Adult Food Protein-induced Enterocolitis Syndromementioning

confidence: 99%

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Food protein‐induced enterocolitis syndrome

Caubet

Cianferoni

Groetch

et al. 2019

Clin Experimental Allergy

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Food protein‐induced enterocolitis syndrome (FPIES) is a non‐IgE‐mediated gastrointestinal food allergic disorder that has gained a major interest the past decade. FPIES prevalence, which still needs to be accurately determine in different populations, appears to be higher than previously thought (ie up to 0.7% in infants in the 1st year of life). FPIES to seafood in adults is also increasingly reported; limited data suggest that adult FPIES is most commonly triggered by shellfish, tends to affect females more than men, is characterized by a significant delay in diagnosis and a prolonged course. The first international consensus guidelines on diagnosis and management of FPIES have been published in 2017, proposing new diagnostic criteria as well as new criteria for a positive oral food challenge. However, there is a need to develop new biomarkers to improve the diagnosis and management of FPIES patients, and this requires a better understanding of the pathophysiology. Recently, the role of T cells has been questioned and a major role of innate immune cells has been suggested in acute FPIES. Regarding the treatment of acute FPIES reaction, ondansetron has emerged as an adjunct to intravenous rehydration in moderate‐severe reactions and as a first‐line treatment in mild reactions. Important information regarding the nutritional management of FPIES patients that might be complex has also been provided in the international guidelines. In this review, we discuss recent advances regarding all those different aspects.

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Section: Different Phenotypes Of Food Protein‐induced Enterocolitis Smentioning

confidence: 99%

Section: Adult Food Protein-induced Enterocolitis Syndromementioning

confidence: 99%

Section: Adult Food Protein-induced Enterocolitis Syndromementioning

confidence: 99%

See 1 more Smart Citation

Food protein‐induced enterocolitis syndrome

Caubet

Cianferoni

Groetch

et al. 2019

Clin Experimental Allergy

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“…FPIES induced by fish is characterized by particularities not found in other foods, ie, it begins later (except those caused by shellfish) and has a later resolution, at least than those produced by milk. FPIES has also been described for fish in adults and adolescents, where it is the second cause after shellfish [18,19].…”

Section: Clinical Aspects Of Fish Allergymentioning

confidence: 99%

What Do We Know About Fish Allergy at the End of the Decade?

Kourani¹,

Corazza²,

Michel³

et al. 2019

J Investig Allergol Clin Immunol

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Fish allergy is one of the most common food allergies. It is usually considered to be IgE-mediated and correlates well with diagnostic tests such as prick tests and/or determination of specific IgE. Avoidance is the recommended treatment and is generally extended to all fish species. However, new clinical presentations have been described. These include non-IgE-mediated disease, monosensitization, and new syndromes that are sometimes associated, surprisingly, with cross-reactivity. Advances in molecular allergy have provided insights into new allergens and have increased our understanding of cross-reactivity. This paper focuses on recent publications providing information for clinicians involved in the management of fish allergy.

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“…There is now emerging research describing a similar non-IgE mediated food allergy in adult patients (5). It appears from the current literature that seafood (crustacean, mollusc, shell sh, and sh) are the most common food described to cause symptoms consistent with FPIES in adults (6)(7)(8). In accordance with the FPIES guideline, the diagnosis of FPIES is made if there is evidence of a supportive medical history and resolution of symptoms with elimination of the causative food, or oral food challenge con rmation if the history is unclear (9).…”

Section: Introductionmentioning

confidence: 99%

Adults with Possible Food Protein-Induced Enterocolitis Syndrome with Crustacean Ingestion

Wong-Pack

Macikunas

et al. 2020

Preprint

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Background: Food protein-induced enterocolitis (FPIES), an entity previously thought to only affect children, has been increasingly described in adults. In this study, we report a Canadian cohort of 19 adolescents and adults with recurrent non-immunoglobulin E (IgE) -mediated gastrointestinal symptoms after crustacean ingestion, consistent with FPIES.Methods: We conducted a retrospective chart review of patients in an outpatient allergy clinic from January 2005 to May 2020. Electronic records were searched using keywords for crustaceans and for symptoms consistent with FPIES. We included patients with gastrointestinal symptoms specifically to crustaceans on more than one occasion, who were 14 years or older at the time of index reaction. Exclusion criteria included symptoms suggestive of an IgE-mediated anaphylactic reaction or a likely alternative diagnosis. We identified 19 patients for our cohort who met the criteria.Results: Our cohort was 68.4% female (13) and 32.6% (6) male. The average age at first reaction to crustaceans was 34 years old with a range of 14 years to 68 years (median = 28 years; IQR = 32 years). Time from ingestion to beginning of symptoms ranged from 3 minutes to 6.5 hours, with an average of 2.8 hours (median = 2 hours; IQR = 3.25 hours). Duration of reaction ranged from less than a minute to over 48 hours, with a mean of 9.4 hours (median = 4 hours; IQR= 7.75 hours). Patients had 4.8 reactions on average; however, number of reactions ranged from 2 to 12.5 (median = 3, IQR = 3). All patients identified a “trigger” food in the crustacean group, and 12 subjects identified additional reactions to other seafood. Conclusions: We hope our case series will better characterize and advance our understanding of this disease entity in adults. There are key differences in the presentation of FPIES in adults compared to children, namely female predominance, difference in solid food trigger, and unpredictable time course. Future studies are needed to examine the pathophysiology and natural history of adult FPIES. Specific guidelines should be developed for the diagnosis and management in adults.Trial Registration: retrospectively registered

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Food protein–induced enterocolitis-like syndrome in a population of adolescents and adults caused by seafood

Cited by 55 publications

References 9 publications

Food protein‐induced enterocolitis syndrome

Food protein‐induced enterocolitis syndrome

What Do We Know About Fish Allergy at the End of the Decade?

Adults with Possible Food Protein-Induced Enterocolitis Syndrome with Crustacean Ingestion

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