Food protein-induced Enterocolitis Syndrome Caused by Fish

Remón, L. Zapatero; Lebrero, Elena Alonso; Fernández, E. Martín; Molero, M. I. Martínez

doi:10.1016/s0301-0546(05)73249-3

Cited by 64 publications

(69 citation statements)

References 15 publications

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“…Other inciting foods include other grains (barley, corn); meat and poultry (beef, chicken, turkey); egg white; vegetables (white potato, sweet potato, squash, string bean); fruit (tomato); legumes (peanut, green pea, lentil); seafood (fish, crustaceans, mollusks, usually with onset in older children and adults); and the probiotic Saccharomyces boulardii [3,20,42,[50][51][52][53][54][55][56][57]. Recently published studies and case reports have added tree nut (type not specified in the study), mushrooms, and egg yolk to this list [24•, 58, 59].…”

Section: Inciting Foodsmentioning

confidence: 99%

Food Protein-Induced Enterocolitis Syndrome, Allergic Proctocolitis, and Enteropathy

Feuille

Nowak‐Węgrzyn

2015

Curr Allergy Asthma Rep

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Food protein-induced enterocolitis (FPIES), allergic proctocolitis (FPIAP), and enteropathy (FPE) are among a number of immune-mediated reactions to food that are thought to occur primarily via non-IgE-mediated pathways. All three are typically present in infancy and are triggered most commonly by cow's milk protein. The usual presenting features are vomiting with lethargy and dehydration in FPIES; bloody and mucous stools in FPIAP; and diarrhea with malabsorption and failure to thrive in FPE. Diagnosis is based on convincing history and resolution of symptoms with food avoidance; confirmatory diagnostic testing other than food challenge is lacking. The mainstay of management is avoidance of the suspected inciting food, with interval challenge to assess for resolution, which usually occurs in the first years of life. Studies published in the past few years clarify common presenting features, report additional culprit foods, address potential biomarkers, and suggest new management strategies.

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Section: Inciting Foodsmentioning

confidence: 99%

Food Protein-Induced Enterocolitis Syndrome, Allergic Proctocolitis, and Enteropathy

Feuille

Nowak‐Węgrzyn

2015

Curr Allergy Asthma Rep

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“…Among the solid foods, rice is considered one of the most common causative foods worldwide [1], but it varies depending on the geographic area. In the Mediterranean countries, such as Spain or Italy, fish is the most important solid food trigger of FPIES [2-5]. …”

Section: Introductionmentioning

confidence: 99%

Oral Food Challenge in Food Protein-Induced Enterocolitis Syndrome by Fish: Is There Any Room for Improvement?

Infante

Martín

Zubeldía

et al. 2019

Int Arch Allergy Immunol

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Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food hypersensitivity usually due to cow’s milk or soy. Among the solid foods, rice is one of the most causative foods worldwide, but it varies depending on the geographic area. In the Mediterranean countries, fish is one of the most important triggers of FPIES. There is not a specific biological marker for the disease that allows us to confirm the diagnosis or to predict when tolerance to the offending food has been achieved, so all patients with a FPIES diagnosis undergo an oral food challenge (OFC) at least once. The OFC is a risky procedure and many patients develop severe symptoms. Objective: We sought to evaluate the safety of a new OFC protocol in children with fish-FPIES. Methods: A retrospective study was performed over a 22-year period (1996–2018). We compared two methodologies used in the OFC: Method 1 that consisted in giving several doses during the same day versus Method 2 that consisted in giving a unique dose per day on 2 or three non-consecutive days. Results: A total of 75 positive OFC with fish done in 40 children were included. Forty-three (57.3%) OFC were performed following Method 1 and 32 (42.7%) with Method 2.The severity of the symptoms of the OFC done with Method 1 was mostly moderate (41.9%) followed by severe (39.5%) and mild (18.6%). The adverse reactions with Method 2 were mostly mild (68.8%) and only 18.8 and 12.5% presented moderate or severe symptoms, respectively. Conclusions: OFC performed in children with fish-FPIES are risky and many patients develop moderate or severe symptoms after this procedure. We propose a new protocol that has demonstrated to improve safety.

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“…[5][6][7][8] El arroz es el alimento sólido que produce SEIPA con mayor frecuencia; además, se asocia a reacciones más graves que otros alimentos. 9 El diagnóstico se basa en la historia clínica, sospecha de alimento causal, exclusión de otras posibles etiologías y, en algunos casos, es necesaria una prueba de provocación oral para confirmar la sospecha diagnóstica, aunque se considera una prueba de riesgo 10 que debe realizarse en el ámbito hospitalario.…”

Section: Discussionunclassified

Un caso inusual de síndrome de enterocolitis inducida por proteínas alimentarias

et al. 2017

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RESUMENEl síndrome de enterocolitis inducido por proteínas alimentarias es un síndrome de hipersensibilidad gastrointestinal a alimentos no mediado por inmunoglobulina E, que, en su forma aguda, se manifiesta con vómitos repetitivos, palidez e hipotonía, que puede acompañarse o no de diarrea y producir un cuadro grave de deshidratación y letargia. Una prueba de provocación oral controlada es, en ocasiones, realizada para confirmar el diagnóstico y el tratamiento consiste en la eliminación del alimento causante. Se presenta el caso de un lactante de 3 meses con varios episodios de síndrome de enterocolitis tras la toma de biberón de leche de fórmula de inicio con tolerancia de otra marca comercial. Se encontraron diferencias en los ingredientes de su composición que podrían ser el origen de la sensibilización. Palabras clave: proteínas alimentarias, enterocolitis, hipersensibilidad a la leche, test de tolerancia oral. ABSTRACTFood protein-induced enterocolitis syndrome is a nonimmunoglobulin E mediated gastrointestinal food hypersensitivity that manifests as profuse, repetitive vomiting, pallor and hypotonia, often with diarrhea leading to severe dehydration and lethargy (sepsis-like symptoms) in the acute setting. An oral food challenge is sometimes performed to confirm the diagnosis and treatment consists of elimination of the food trigger(s) from the diet. We report a case of a 3-monthsold infant with several episodes of food protein-induced enterocolitis syndrome after taking infant formula milk with tolerance of another trademark. Differences in the composition of its ingredients could be the cause of the sensitization. Un caso inusual de síndrome de enterocolitis inducida por proteínas alimentarias Unusual case of food protein-induced enterocolitis syndrome INTRODUCCIÓNEl síndrome de enterocolitis inducido por proteínas alimentarias (SEIPA) es una alergia alimentaria no mediada por inmunoglobulina E (IgE) que suele aparecer en el primer año de vida. Su clínica más común son los cuadros de vómitos repetidos, que comienzan entre una y cuatro horas tras la ingestión del alimento causal, acompañados de afectación del estado general y signos de hipotensión por deshidratación, incluso, con aspecto séptico, que ceden lentamente a lo largo de varias horas. Pueden seguirse de una o varias deposiciones diarreicas (acompañadas o no de sangre), pero predominan los síntomas digestivos altos.1 Los desencadenantes más frecuentes son la leche de vaca, la soja, el arroz y la avena. El diagnóstico es clínico y puede llegar a ser difícil por la ausencia de sintomatología alérgica típica y el inicio retardado tras la ingesta. Tiene un pronóstico favorable: la mayoría de los niños consiguen la resolución entre los 3 y los 5 años. 2Se presenta un caso clínico de SEIPA diagnosticado en nuestro centro. CASO CLÍNICOLactante de 3 meses nacido a término, alimentado desde el nacimiento con leche de fórmula sin antecedentes personales de interés. Fue evaluado en el Servicio de Urgencias por un episodio de irritabilidad, vómitos repet...

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Food protein-induced Enterocolitis Syndrome Caused by Fish

Cited by 64 publications

References 15 publications

Food Protein-Induced Enterocolitis Syndrome, Allergic Proctocolitis, and Enteropathy

Food Protein-Induced Enterocolitis Syndrome, Allergic Proctocolitis, and Enteropathy

Oral Food Challenge in Food Protein-Induced Enterocolitis Syndrome by Fish: Is There Any Room for Improvement?

Un caso inusual de síndrome de enterocolitis inducida por proteínas alimentarias

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