Remission of Acute Food Protein-Induced Enterocolitis Syndrome Confirmed by Oral Food Challenges in Japan

Nishimura, Koji; Yamamoto‐Hanada, Kiwako; Sato, Miori; Toyokuni, Kenji; Ogita, Hiroya; Kiguchi, Tomoyuki; Miyagi, Yoshitsune; Inuzuka, Yusuke; Saito‐Abe, Mayako; Irahara, Makoto; Ishikawa, Fumi; Kabashima, Shigenori; Miyaji, Yoshiyuki; Fukuie, Tatsuki; Nomura, Ichiro; Ohya, Yukihiro

doi:10.3390/nu14194158

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…Acute FPIES should be considered one of the differential diagnoses of vomiting, and pediatric medical staff should appropriately refer suspected cases to a specialist. 14,15…”

Section: Discussionmentioning

confidence: 99%

“…We encounter acute FPIES at the ED, and emergency physicians and allergists require more education about acute FPIES and the FPIES diagnostic criteria following the international consensus guidelines. Acute FPIES should be considered one of the differential diagnoses of vomiting, and pediatric medical staff should appropriately refer suspected cases to a specialist 14,15 …”

Section: Discussionmentioning

confidence: 99%

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Food protein–induced enterocolitis syndrome is an important differential diagnosis of vomiting in pediatric emergency

Ohnishi,

Yamamoto‐Hanada,

Sato

et al. 2023

Pediatrics International

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BackgroundThe aim of this study was to clarify the clinical characteristics and management of infants with suspected acute food protein–induced enterocolitis syndrome (FPIES) who presented to the pediatric emergency department (ED) before and after the guidelines were published.MethodsThis was a retrospective cohort study. We classified the infants as “acute FPIES‐like symptoms” who were younger than 12 months of age and visited the pediatric ED of the National Center for Child Health and Development due to vomiting 1–4 h after food ingestion without any causative disease, such as infection. The medical records of those infants in 2015 and 2021 were reviewed. We used the nonparametric Mann–Whitney U test to compare two groups for continuous variables, whereas chi‐squared or Fisher's exact tests were used for nominal variables.ResultsThe number of infants with acute FPIES‐like symptoms was 15 (13%) in 2015 and 14 (15%) in 2021. The trigger foods were cow's milk or dairy products in half of the infants, and five as a result of ingestion of hen's eggs in 2021, compared to zero cases in 2015. Five in 2015 and 12 in 2021 required examination at the ED. Three in 2015 and six in 2021 met the diagnostic criteria for acute FPIES in the international consensus guidelines. The emergency physicians did not record at least four minor criteria for acute FPIES in seven in 2015 and five in 2021. No infants (0%) in 2015 and two (14%) in 2021 were referred to the allergy department by an emergency physician.ConclusionsAcute FPIES should be considered one of the differential diagnoses of vomiting, and pediatric medical staff should be aware of FPIES diagnostic criteria and appropriately refer suspected cases to a specialist.

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“…Acute FPIES should be considered one of the differential diagnoses of vomiting, and pediatric medical staff should appropriately refer suspected cases to a specialist. 14,15…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Food protein–induced enterocolitis syndrome is an important differential diagnosis of vomiting in pediatric emergency

Ohnishi,

Yamamoto‐Hanada,

Sato

et al. 2023

Pediatrics International

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“…Rice and oats are recognized as major causes of SFF [ 4 ], but other foods can also trigger this condition [ 5 ]. Cases of FPIES to hen’s eggs, especially egg yolk, have recently increased [ 6 ]. Although soy is a major trigger food for CSF [ 2 ], few cases of soy-triggered SFF have been described.…”

Section: Introductionmentioning

confidence: 99%

Two Pediatric Cases of Food Protein-Induced Enterocolitis Syndrome to Soy Eaten as an Infant Food

Maeda¹,

Kusama²,

Atsumi³

et al. 2023

Cureus

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Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy that can be caused not only by infant formula but also by infant food. Herein, we report two pediatric cases of FPIES to solid soy foods, such as tofu. The patients presented with repetitive vomiting after eating the trigger food as infant food. Although both cases promptly recovered following the cessation of the trigger food, one case required rapid intravenous hydration for compensated shock. Both cases were diagnosed with FPIES to soy based on the typical presentation and parental interviews regarding food exposure. One case had a positive response to an oral food challenge for tofu, and both cases were negative for soy-specific IgE. One of our cases did not develop FPIES from fermented soy products despite having soy-triggered FPIES. The fermentation process may reduce the allergenicity of soy, but further evidence is required to confirm this hypothesis. There are various trigger foods for solid food FPIES (SFF), and these differ among countries. Solid food FPIES to soy is more common in Japan than in other countries due to the frequent use of tofu in infant food. Increased international awareness of the possibility of tofu-triggered FPIES may be warranted due to the rising global use of tofu in infant food.

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A nationwide survey of non-IgE-mediated gastrointestinal food allergies in neonates and infants

Suzuki,

Morisaki,

Nagashima

et al. 2024

Allergology International

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Remission of Acute Food Protein-Induced Enterocolitis Syndrome Confirmed by Oral Food Challenges in Japan

Cited by 5 publications

References 21 publications

Food protein–induced enterocolitis syndrome is an important differential diagnosis of vomiting in pediatric emergency

Food protein–induced enterocolitis syndrome is an important differential diagnosis of vomiting in pediatric emergency

Two Pediatric Cases of Food Protein-Induced Enterocolitis Syndrome to Soy Eaten as an Infant Food

A nationwide survey of non-IgE-mediated gastrointestinal food allergies in neonates and infants

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