Early diagnosis and intervention induce early tolerance in egg yolk-associated FPIES.

Abstract

To the Editor, Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E (IgE) mediated food allergy that predominantly affects infants and is characterized by repetitive vomiting that occurs 1-4 h after the ingestion of causative food. The etiology and underlying mechanisms of FPIES are not well understood. Recently, egg yolk (EY) has been recognized as a major causative food of FPIES. 1,2 Most FPIES patients achieve tolerance with age; 3 however, the practice management of EY-associated FPIES (EY-FPIES) has yet to be established. In a preliminary analysis of EY-FPIES, we found that the patients who acquired tolerance to EY had been diagnosed at a significantly younger age than non-tolerated patients despite no difference in the age of onset between both patients. This suggested that the early diagnosis and intervention is beneficial for tolerance acquisition in EY-FPIES. To investigate this further, we compared clinical outcomes between the early and late diagnosis of EY-FPIES.