Food aversion and poor weight gain in food protein–induced enterocolitis syndrome: A retrospective study

Su, Kuan‐Wen; Patil, Sarita U.; Stockbridge, Jennifer L.; Martin, Victoria M.; Virkud, Yamini; Huang, Jing‐Long; Shreffler, Wayne G.; Yuan, Qian

doi:10.1016/j.jaci.2020.01.001

Cited by 44 publications

(63 citation statements)

References 16 publications

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“…Diarrhea can also follow 5 to 10 h later, although this is a less common feature (25–50%). Infants often appear septic, presenting with symptoms of lethargy (65–100%), pallor (30–90%) and hypothermia (5%) [ 24 , 26 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ]. Symptoms may be quite severe, with up to 15% experiencing hemodynamic instability [ 65 , 68 ].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Chronic FPIES, on the other hand, presents with chronic watery diarrhea (occasionally with blood or mucus), intermittent emesis, abdominal distension, and/or poor weight gain. In a subgroup of patients, symptoms progressively worsen and can lead to dehydration (15–45%) and metabolic disturbances (5%) [ 26 , 62 , 64 ]. Typically, chronic FPIES will occur with persistent exposure to cow’s milk or soy-based formula, while intermittent exposure to solid foods such as rice is more likely to cause an acute presentation [ 24 ].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…In contrast, a majority (up to 80%) of those with FPIES to solid food tend to have multiple food triggers [ 24 , 26 , 65 ]. Frequently, children will react upon their first exposure to the incriminated food [ 64 ], indicating that prior sensitization is either not required or occurs through other routes such as the skin.…”

Section: Reported Food Triggersmentioning

confidence: 99%

“…Allergy testing, which includes epicutaneous skin testing and the detection of serum food-specific IgE, is usually negative, and not warranted for the investigation of non-IgE-GI-FA [ 2 , 3 , 8 ]. However, up to 25% of FPIES patients will develop sIgE to their food trigger [ 23 , 26 , 64 ]. These patients have what is termed an atypical form of FPIES, which can present with a protracted course and may increase the risk of developing immediate allergic reactions to the culprit food [ 26 , 95 ].…”

Section: Paraclinical Investigations and Biomarkersmentioning

confidence: 99%

“…Efforts should therefore be put in place to limit unnecessary elimination diets, as even single-food avoidance can lead to significant nutritional deficiency [ 166 ], although those who avoid a greater number of foods may be at an increased risk [ 167 ]. Children with non-IgE-GI-FA can experience poor growth, which may be attributed to increased losses due to intestinal malabsorption and/or to limited food intake due to feeding difficulties, which are found in up to 30% of these patients [ 64 , 168 ]. Consequently, both weight [ 64 , 168 , 169 ] and height [ 169 ] may be affected.…”

Section: Managementmentioning

confidence: 99%

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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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Section: Clinical Manifestationsmentioning

confidence: 99%

Section: Clinical Manifestationsmentioning

confidence: 99%

Section: Reported Food Triggersmentioning

confidence: 99%

Section: Paraclinical Investigations and Biomarkersmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

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

2020

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Getting away from death fear: How disease threat drives consumers' colorfulness seeking

Yi,

Luo,

Wang

et al. 2023

J of Consumer Behaviour

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The COVID‐19 pandemic had significant effects on the health and wellbeing of people worldwide. However, in the post‐epidemic era, we still know very little about how disease threat shapes consumer psychology and behavior. To fill this gap in knowledge, the present study explores the effect of disease threat on a particular sensory preference of consumers, that is, a preference for colorfulness. Based on compensatory consumption theory, we propose the following: (1) consumers prefer colorful products and brand logos to compensate for both disease threat and chronically perceived disease threat; (2) the underlying mechanism for this effect is death‐related thoughts, in that disease threat leads to more death‐related thoughts, which in turn enhance colorfulness seeking; (3) the impact of disease threat on consumers' colorfulness seeking diminishes among high sensation seekers. A set of four studies, adopting both lab and survey methods, using various manipulations and measures, and testing diverse samples, provide convergent evidence for these hypotheses. Moreover, six alternative explanations were ruled out to further elucidate the psychological process under examination in this study. This paper contributes to the literature on consumer behavior, sensory marketing, terror management theory, and compensatory consumption. Implications of these findings are discussed.

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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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Food aversion and poor weight gain in food protein–induced enterocolitis syndrome: A retrospective study

Cited by 44 publications

References 16 publications

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

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

Getting away from death fear: How disease threat drives consumers' colorfulness seeking

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

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