Food protein‐induced enterocolitis syndrome by fish: Not necessarily a restricted diet

Abstract

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food hypersensitivity usually due to cow's milk or soy. Recent researches show that fish is 1 of the most important triggers of FPIES in the Mediterranean countries. Due to the risk of multiple-food FPIES, avoiding foods in the same category or that often occur together may be reasonable. The aim of this study was to evaluate the evolution and follow-up of FPIES related to fish over a period of 20 years. We describe the clinical features of our population, discuss different approaches to oral food challenges, and analyze the possibility of introducing the culprit fish or other nonrelated fish to avoid unnecessary restricted diets.

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

“…Finally, as we previously reported, children with FPIES by fish tolerate better an alternative fish than the offending one [15]. In our experience, we propose a safer way to the general management of FPIES by fish (Fig.…”

“…However, if the OFC was with an alternative fish or if the symptoms had been mild, we performed it in 2 days. As we previously reported, children with FPIES due to fish could tolerate canned tuna and swordfish; therefore, when the OFC was performed with one of this fish, we did it on 2 non-consecutive days [15]. …”

A modified oral food challenge in children with food protein‐induced enterocolitis syndrome

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

“…In particular, Infante et al performed OFCs on 2 non‐consecutive days: on the first day, the child was given a single dose slightly <50% of the serving age. If tolerated and the child remained free of symptoms for 48 hours, a full serving dose was offered.…”

“…A variety of protocols for FPIES-related OFC have been published, differing in amount and number of doses and timing. [3][4][5][6][7][8][9] In particular, Infante et al 3 performed OFCs on 2 non-consecutive days: on the first day, the child was given a single dose slightly <50% of the serving age. If tolerated and the child remained free of symptoms for 48 hours, a full serving dose was offered.…”