Nuestra experiencia en enterocolitis inducida por proteínas de la dieta en la consulta de alergología pediátrica

Ajami, Rasha Isabel Pérez; Sari, Silvia Karina Carrión; Mazas, Yolanda Aliaga; Calvo, Javier Boné; Abadía, María Isabel Guallar

doi:10.1016/j.anpedi.2019.09.011

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…CM, for example, is the most common trigger food in Italy, USA, and Greece, 31,32,33 confirming the results of our population; rice ranks first in Australia 33,34 and is becoming increasingly frequent in the USA. 29 Fish is prevalent in Mediterranean countries, i.e., Italy, Spain, and Gre ece, 31,35,36,37 but in our cohort, it was not as widespread as egg (19%). Similarly to Miceli Sopo S. et al's study, 38 also among our patients with FPIES to fish (n = 11, 13%), the main trigger fish was the sole (n = 8, 73%).…”

Section: Discussioncontrasting

confidence: 54%

Frequency of positive oral food challenges and their outcomes in the allergy unit of a tertiary-care pediatric hospital

Ballini

Gavagni

Guidotti

et al. 2021

aei

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Introduction and objective: The oral food challenge (OFC) is the gold standard to diagnose food allergy (FA); however, it is not a procedure free from the risk of having significant allergic reactions, even life-threatening.The aims of our study were to evaluate the frequency of positive OFCs performed in chil-dren with a suspected diagnosis of IgE- and non-IgE–mediated (food protein–induced enterocolitis syndrome (FPIES)) FA and how the failed challenges were managed.Materials and methods: A retrospective chart review was done on all children who have had OFCs in a tertiary-care pediatric allergy unit from 2017 to 2019.Results: 682 patients were enrolled and 2206 challenges were performed: 2058 (93%) for IgE-mediated FA and 148 (7%) for FPIES. There were 262 (11.8%) challenge failures. The transfer to the emergency department was required 3 times (1.1%). None of the failed challenges resulted in death or hospitalization and 13.3% challenges did not require any treatment.Conclusions: Our findings confirm that food challenges can be performed safely in a specialized setting by well-trained personnel; all food challenge reactions, even the most serious, were reversible, thanks to a prompt recognition and treatment that generally did not worsen over time.

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Section: Discussioncontrasting

confidence: 54%

Frequency of positive oral food challenges and their outcomes in the allergy unit of a tertiary-care pediatric hospital

Ballini

Gavagni

Guidotti

et al. 2021

aei

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“…* Soy allergy likely underrepresented by these studies. 1 From Ruffner et al [95] (n = 462), Caubet et al [26] (n = 160), Blackman et al [65] (n = 74), Maciag et al [25] (n = 441), Su et al [64] (n = 203); 2 From Ludman et al [66] (n = 54); 3 From Vazquez-Ortiz [101] (n = 81), Diaz et al [60] (n = 120), Pérez Ajami et al [104] (n = 135); 4 From Miceli Sopo et al [67] (n = 66); 5 From Mehr et al [97] (n = 35), Mehr et al [21] (n = 230); 6 From Arik Yilmaz et al [105] (n = 27); 7 From Kuitunen et al [28] (n = 54); 8 From Lake et al [84] (n = 95); 9 From Kaya et al [87] (n = 60), Arik Yilmaz et al [105] (n = 37), Erdem et al [86] (n = 77), Cetinkaya et al [85] (n = 185).…”

Section: Reported Food Triggersmentioning

confidence: 99%

“…When tolerated, a soy-based formula is an acceptable alternative, although it is usually avoided because of the high co-reactivity with cow's milk, seen in up to 40-60% of patients with FPIES, and in 10-30% of patients with FPE and FPIAP [96,[158][159][160]. However, co-sensitization to cow's milk and soy has mainly been reported in studies from the United States, and may be less frequent in other populations [19,62,104,105]. In contrast to FPIAP, symptomatic FPIES is very rare in the breastfed infant.…”

Section: Food Eliminationmentioning

confidence: 99%

Non-IgE-Mediated Gastrointestinal Food Allergies in Children: An Update

2020

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Non-immunoglobulin E-mediated gastrointestinal food allergic disorders (non-IgE-GI-FA) include food protein-induced enterocolitis syndrome (FPIES), food protein-induced enteropathy (FPE) and food protein-induced allergic proctocolitis (FPIAP), which present with symptoms of variable severity, affecting the gastrointestinal tract in response to specific dietary antigens. The diagnosis of non-IgE-GI-FA is made clinically, and relies on a constellation of typical symptoms that improve upon removal of the culprit food. When possible, food reintroduction should be attempted, with the documentation of symptoms relapse to establish a conclusive diagnosis. Management includes dietary avoidance, nutritional counselling, and supportive measures in the case of accidental exposure. The prognosis is generally favorable, with the majority of cases resolved before school age. Serial follow-up to establish whether the acquisition of tolerance has occurred is therefore essential in order to avoid unnecessary food restriction and potential consequent nutritional deficiencies. The purpose of this review is to delineate the distinctive clinical features of non-IgE-mediated food allergies presenting with gastrointestinal symptomatology, to summarize our current understanding of the pathogenesis driving these diseases, to discuss recent findings, and to address currents gaps in the knowledge, to guide future management opportunities.

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Food protein‐induced enterocolitis syndrome: A large French multicentric experience

Lemoine¹,

Colas

et al. 2022

Clinical & Translational All

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Background Food protein‐induced enterocolitis syndrome (FPIES) is a non‐IgE‐mediated food allergy, with potential dehydration secondary to vomiting. Differences exist regarding culprit foods, and age of tolerance depending on the country of origin. We aimed at describing the characteristics of a French population of children with FPIES, and define risk factors for failure during challenge. Methods Data from 179 children who were referred for FPIES in two pediatric tertiary centers between 2014 and 2020 were retrospectively collected. The diagnosis of FPIES was based on international consensus guidelines. Clinical characteristics, culprit food, and age at resolution were assessed. Tolerance was defined as no adverse reaction after OFC or accidental exposure. Results In the 192 described FPIES, the age at first symptoms was 5.8 months old. The main offending foods were cow's milk (60.3%), hen's egg (16.2%), and fish (11.7%). Single FPIES was observed in 94.4% and multiple FPIES in 5.6% of cases. The age at resolution of FPIES was 2.2 years old, and resolution occurred later for fish than for milk (2.9 years vs. 2.0, p = 0.01). Severe acute FPIES was a risk factor for delayed resolution (RR: 3.3 [1.2–9.2]), but not IgE sensitization. Performing a food challenge within 12 months after the first reaction increased the risk of failure (OR: 2.6 [1.1–6.6]). Conclusion In this French cohort of children with FPIES, the main culprit foods were ubiquitous. Rice, oat, and soy were rarely or not involved. Multiple FPIES was infrequent. Our data confirmed the overall good prognosis of FPIES, the later resolution of FPIES to fish and in the case of severe acute FPIES.

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Nuestra experiencia en enterocolitis inducida por proteínas de la dieta en la consulta de alergología pediátrica

Cited by 4 publications

References 15 publications

Frequency of positive oral food challenges and their outcomes in the allergy unit of a tertiary-care pediatric hospital

Frequency of positive oral food challenges and their outcomes in the allergy unit of a tertiary-care pediatric hospital

Non-IgE-Mediated Gastrointestinal Food Allergies in Children: An Update

Food protein‐induced enterocolitis syndrome: A large French multicentric experience

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