Usefulness of thymus and activation‐regulated chemokine (TARC) for FPIES diagnosis

Makita, Eishi; Sugawara, Daisuke; Kuroda, Sae; Itabashi, Kae; Ichihashi, Ko

doi:10.1111/pai.13649

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…We evaluated the following laboratory tests at the time of peripheral intravenous line placement before the OFC: levels of white blood cells, neutrophils, eosinophils, C-reactive proteins (CRPs), and thymus and activation-regulated chemokine [ 7 ]. The serum levels of total IgE and antigen-specific IgE were measured using an ImmunoCAP system (Thermo Fisher Scientific, Waltham, MA, USA).…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2022

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The oral food challenge test (OFC) is the gold standard for evaluating the remission of food protein-induced enterocolitis syndrome (FPIES). Few acute FPIES remissions confirmed by OFC were reported. This study aimed to examine the OFC for Japanese children with acute FPIES to evaluate its remission. A retrospective cohort study was performed on children with acute FPIES with remission evaluation by OFC based on one food challenge dose (1/50, 1/10, 1/2, and full dose per day). Acute FPIES remission was observed in 65.2% of patients (15/23 patients). Vomiting episodes occurred with 1/50 full doses on the first day among 75% of positive patients. The median duration between the onset and OFC was 14 months (IQR, 8–24 months). Soy was the most common causative food, followed by egg yolk, milk, and wheat. All patients could receive OFC safely without intensive care unit care, based on the FPIES OFC protocol. The remission rate of acute FPIES was high. However, vomiting episodes commonly occurred with 1/50 full doses on the first day. This study suggested that our OFC protocol for acute FPIES was safe and feasible, but it might be safer for some patients to start at a minimal loading dose.

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Section: Methodsmentioning

confidence: 99%

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

et al. 2022

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“…48,49 It is a Th2 chemokine that is produced by fibroblasts, endothelial cells, and keratinocytes. 49,50 Although TARC is used to assess patients with atopic dermatitis, patients with symptoms of FPIES found to have an elevated level. 49,50 Makita et al have performed a longitudinal evaluation of TARC levels on FPIES patients which revealed a high level at 6 hours following the ingestion, and even higher level after 24 hours of the ingestion.…”

Section: Clinical Manifestations and Diagnosis Fpiap Fpies Fpementioning

confidence: 99%

“…49,50 Although TARC is used to assess patients with atopic dermatitis, patients with symptoms of FPIES found to have an elevated level. 49,50 Makita et al have performed a longitudinal evaluation of TARC levels on FPIES patients which revealed a high level at 6 hours following the ingestion, and even higher level after 24 hours of the ingestion. 50 Therefore, they recommended TARC measurement after 24 hours for diagnosing FPIES.…”

Section: Clinical Manifestations and Diagnosis Fpiap Fpies Fpementioning

confidence: 99%

“…49,50 Makita et al have performed a longitudinal evaluation of TARC levels on FPIES patients which revealed a high level at 6 hours following the ingestion, and even higher level after 24 hours of the ingestion. 50 Therefore, they recommended TARC measurement after 24 hours for diagnosing FPIES. 50 In FPE, patients often develop iron deficiency anemia and hypoproteinemia, 51 which present in less than 15% of the patients with FPIAP.…”

Section: Clinical Manifestations and Diagnosis Fpiap Fpies Fpementioning

confidence: 99%

“…50 Therefore, they recommended TARC measurement after 24 hours for diagnosing FPIES. 50 In FPE, patients often develop iron deficiency anemia and hypoproteinemia, 51 which present in less than 15% of the patients with FPIAP. 32,52 Peripheral eosinophilia is a prominent feature in FPE and FPIAP and can be found in patients with FPIES.…”

Section: Clinical Manifestations and Diagnosis Fpiap Fpies Fpementioning

confidence: 99%

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Perspectives on Non-IgE-Mediated Gastrointestinal Food Allergy in Pediatrics: A Review of Current Evidence and Guidelines

Al-Iede¹,

Sarhan²,

Alshrouf³

et al. 2023

JAA

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Food allergy is an immune-mediated disease that can result in considerable morbidity and even mortality, with a significant negative impact on patients' quality of life. It is characterized by allergic symptoms that can occur shortly after a relevant food allergen ingestion, or can be delayed or chronic, which make it more difficult for diagnosis. The symptoms of this disease can range from mild to severe, and rarely can cause anaphylaxis, a life-threatening allergic reaction. The prevalence of non-immunoglobulin E (IgE)mediated food allergy is poorly established outside of cow's milk allergy, with an adjusted incidence ranging between 0.13% and 0.72%. Several disorders are classified as non-immunoglobulin E (IgE)-mediated food allergies that predominantly affect the gastrointestinal tract including food protein-induced enterocolitis syndrome (FPIES), food protein-induced allergic proctocolitis (FPIAP), food protein-induced allergic enteropathy (FPE), and food protein-induced dysmotility disorders (GORD and constipation). Eosinophilic esophagitis (EoE) is listed in this group, even though it considered by some authorities to be mixed reaction with both IgE and cell-mediated immune response to be involved in the reaction. The most common types of non-IgE-mediated food allergy are food protein-induced enterocolitis syndrome (FPIES) and food protein-induced allergic proctocolitis (FPIAP). These disorders typically present in infancy and are often triggered by cow's milk protein. Patients with FPIES present with profuse emesis and dehydration, while FPIAP patients present with hematochezia in otherwise healthy infants. Since there are no specific confirmatory non-invasive diagnostic laboratory tests, the diagnosis is usually made clinically when typical symptoms improve upon the removal of the culprit food. Food reintroduction should be attempted, when possible, with documentation of symptoms of relapse to confirm the diagnosis. The management includes dietary avoidance, supportive treatment in the case of accidental exposure, and nutritional counseling. This review focuses on the clinical manifestations, epidemiology, management, and recent guidelines of the most common non-IgEmediated food hypersensitivity disorders (FPIES, FPIAP, and FPE).

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Buckwheat Allergy in Asia

Kajita,

Yoshida

2024

Curr Allergy Asthma Rep

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Usefulness of thymus and activation‐regulated chemokine (TARC) for FPIES diagnosis

Cited by 6 publications

References 10 publications

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

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

Perspectives on Non-IgE-Mediated Gastrointestinal Food Allergy in Pediatrics: A Review of Current Evidence and Guidelines

Buckwheat Allergy in Asia

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