Poor utility of atopy patch test in predicting tolerance development in food protein-induced enterocolitis syndrome

Järvinen, Kirsi M.; Caubet, Jean-Christoph Roger J-P; Sickles, Laura; Ford, Lara S.; Sampson, Hugh A.; Nowak‐Węgrzyn, Anna

doi:10.1016/j.anai.2012.06.020

Cited by 70 publications

(40 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This discrepancy may be attributable to the fact that Jarvinen et al considered only palpable infiltration as a positive reaction, the median age in their study was older (3.3 years; range, 1.5-16.8 years) and the median time since the most recent FPIES episode was longer (24.5 months, range, 14.5-79 months) before the OFC, while Fogg's (6) patients represent a group of children with more "active" disease. Probably, the negative APT is a result of a reduction in activation capacity of responsible T cells over time, while there is not the same reduction in the gut mucosa during a positive OFC (25).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Jarvinen et al (25) performed APT on children with FPIES before OFC to monitor tolerance development; however, they found an APT sensitivity of 11.8%, specificity of 85.7%, positive predictive value of 40%, and negative predictive value of 54.5% vs sensitivity of 100%, specificity of 71%, positive predictive value of 75% and negative predictive value of 100% by Fogg et al (6). This discrepancy may be attributable to the fact that Jarvinen et al considered only palpable infiltration as a positive reaction, the median age in their study was older (3.3 years; range, 1.5-16.8 years) and the median time since the most recent FPIES episode was longer (24.5 months, range, 14.5-79 months) before the OFC, while Fogg's (6) patients represent a group of children with more "active" disease.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Usefulness of Atopy Patch Test on a Child with Milk Protein-Induced Enterocolitis Syndrome: A Case Report

Scaparrotta

Pillo

Consilvio

et al. 2013

Int J Immunopathol Pharmacol

View full text Add to dashboard Cite

We describe the case of a child affected by milk-protein induced enterocolitis, in which oral challenge with corn was performed without symptoms after a negative specific Atopy Patch Test. Food protein-induced enterocolitis syndrome (FPIES) is an uncommon non-IgE-mediated gastrointestinal food hypersensitivity of infancy, characterized by severe vomiting and diarrhea arising within 1 to 3 hours after ingestion of the causative food. Little is known about the pathophysiology of FPIES. The absence of food-specific IgE as demonstrated by negative skin prick tests suggests that the disease is not caused by an early onset IgE-mediated reaction. Atopy Patch Test has been described as sensitive and predictive in this syndrome. The hypothesis on the immunological pathogenesis has been discussed on the basis of literature data.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Usefulness of Atopy Patch Test on a Child with Milk Protein-Induced Enterocolitis Syndrome: A Case Report

Scaparrotta

Pillo

Consilvio

et al. 2013

Int J Immunopathol Pharmacol

View full text Add to dashboard Cite

show abstract

“…The atopy patch test has been evaluated in 2 studies with conflicting results regarding its accuracy; at present, the atopy patch test is not recommended for diagnosing FPIES [49,51].…”

Section: Atopy Patch Testmentioning

confidence: 99%

“…Data from a challenge-based study in Korea show that CM-FPIES and soy FPIES may resolve significantly more rapidly than previously assumed [25]. In pooling data from multiple small cohorts, patients seem to be able to tolerate CM at around 3 years of age, although results from 2 recent large cohorts showed that tolerance developed later [13,15,21,24,25,37,38,[45][46][47][48][49][50][51][52][53][54][55][56][57][58]. In a large US case series, the median age of resolution for CM-FPIES was 5.1 years, and in the UK, 25% of the patients had persistent CM-FPIES at 8 years of age [59].…”

Section: Fpies Caused By Cm/soymentioning

confidence: 99%

Food Protein–Induced Enterocolitis Syndrome

Nowak‐Węgrzyn

Jarocka-Cyrta

Castro

2017

J Investig Allergol Clin Immunol

View full text Add to dashboard Cite

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-, cell-mediated food allergy of unknown prevalence and pathophysiology. Onset is typically during the first year of life; seafood-induced FPIES may start in adulthood. Acute FPIES manifests within 1-4 hours after ingestion with repetitive emesis, pallor, and lethargy progressing to dehydration and hypovolemic shock in 15% of cases. Chronic FPIES manifests with intermittent emesis, watery diarrhea, and poor growth progressing to dehydration and hypovolemic shock over a period of days to weeks. Chronic FPIES has been only reported in infants aged less than 3 months fed with cow milk (CM) or soy formula. The most common triggers are CM, soy, rice, and oat. Diagnosis of FPIES relies on recognition of a pattern of clinical symptoms and may be missed owing to the absence of typical allergic symptoms (eg, urticaria, wheezing) and delayed onset in relation to food ingestion. Physician-supervised food challenge is recommended if diagnosis or the trigger food is not clear and to evaluate for resolution. Testing for food-specific IgE is usually negative, although a subset of patients, usually with CM-induced FPIES may develop sensitization to foods. Such atypical FPIES tends to have a more prolonged course. Despite the potential severity of the reactions, no fatalities have been reported, and FPIES has a favorable prognosis. In most cases, FPIES resolves by age 3-5 years, although persistence of CM-induced FPIES and soy FPIES into adulthood has been reported. The first international consensus guidelines on diagnosis and management of FPIES were published in 2017. Given that the pathophysiology of FPIES is poorly understood, there are no diagnostic biomarkers and no therapies to accelerate resolution. These unmet needs warrant future investigations to improve the care of patients with FPIES. Key words: FPIES. Food protein-induced enterocolitis syndrome. Non-IgE-mediated food allergy. Food allergy. Cow milk allergy. ResumenSEIOA es una alergia alimentaria con patofisiología y prevalencia desconocidas, que típicamente comienza en el primer año de vida, mientras que la producida por pescado suelo tener su comienzo en adultos. La forma aguda se manifiesta entre la hora y 4 horas tras la ingesta del alimento con emesis, palidez, letargia progresiva por deshidratación y shock hipovolémico en el 15% de los casos. La forma crónica se manifiesta con emesis intermitente, diarreas y crecimiento pobre con progresión hacia la deshidratación y shock hipovolémico en un periodo de días o semanas. La forma crónica se ha podido observar únicamente en niños menores de 3 años alimentados con leche de vaca o fórmula de soja. Los desencadenantes más frecuentes son la leche de vaca, la soja, el arroz y avena. El diagnóstico es clínico y puede ser difícil debido a la ausencia de síntomas alérgicos típicos (urticaria, asma…) y a la relación retardada con la ingesta. Es recomendable la provocación controlada si el diagnóstico clínico o el alimento implicado no son claros y tamb...

show abstract

“…The atopy patch test has been tested in several studies of FPIES, with conflicting results [16, 37, 38], thus it is not recommended in routine practice.…”

Section: Food Protein-induced Enterocolitis Syndromementioning

confidence: 99%

Food Protein-Induced Enterocolitis Syndrome and Proctocolitis

Dupont¹

2018

Ann Nutr Metab

View full text Add to dashboard Cite

Non-IgE-mediated, also labeled cell-mediated, allergic reactions to foods are more common than usually thought and probably account for approximately more than 40% of cases of cow’s milk allergy during infancy and young childhood. Food allergy is now described in the form of syndromes, among which food protein-induced enterocolitis syndrome (FPIES) and food protein-induced allergic proctocolitis (FPIAP) are gaining increased recognition. FPIES occurs in infancy but may also occur in older children and in adults. The dominant symptom is emesis, repetitive in the chronic FPIES form and explosive in the acute form. Acute FPIES begins 1– 4 h following ingestion of the offending food. Diarrhea is frequent, between 5 and 10 h later, and may be accompanied by lethargy and dehydration, which both characterize severity. Cow’s milk is the most frequent food trigger, followed by soy. FPIES may develop up to 1 year of age, but may also occur in the newborn, and is possible in exclusively breastfed infants, in relation with the mother’s consumption of offending foods. FPIES may occur to solid foods (grains like rice or oat, meats, fish, egg, and vegetables). When starting during infancy, FPIES has a good prognosis and disappears grossly at 2 years of age. FPIES to fish or shellfish is more frequent in older children and adults and is long lasting. International consensus guidelines for the diagnosis and management of FPIES have been published recently. FPIAP starts in the first few months of life and is typically manifested with rectal bleeding in well-appearing breastfed infants during the first months of life in reaction to cow’s milk consumed by the mother. The condition is transient but represents one of the major causes of colitis during infancy.

show abstract

Poor utility of atopy patch test in predicting tolerance development in food protein-induced enterocolitis syndrome

Cited by 70 publications

References 8 publications

Usefulness of Atopy Patch Test on a Child with Milk Protein-Induced Enterocolitis Syndrome: A Case Report

Usefulness of Atopy Patch Test on a Child with Milk Protein-Induced Enterocolitis Syndrome: A Case Report

Food Protein–Induced Enterocolitis Syndrome

Food Protein-Induced Enterocolitis Syndrome and Proctocolitis

Contact Info

Product

Resources

About