Food protein–induced enterocolitis syndrome: Increased prevalence of this great unknown—results of the PREVALE study

Alonso, Sara Bellón; Ezquiaga, Jorge García; Berzal, Patricia Torija; Tardón, Sara Díaz; José, María; López, P.; Bermejo, Teresa; Teruel, Sergio Quevedo; Zudaire, Luis Ángel Echeverría

doi:10.1016/j.jaci.2018.08.045

Cited by 78 publications

(55 citation statements)

References 7 publications

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“…1 Data derived from single-center birth cohorts from Israel and Spain estimated cumulative incidence rates of FPIES in infancy between 0.34% and 0.7%. 4,5 In contrast, a national study of pediatric disease surveillance data with utilization of a questionnaire and a strict case definition estimated a cumulative incidence rate of 0.015% among Australian infants. 6 Collectively, these data suggest that FPIES is more common than appreciated.…”

Section: Food Protein-induced Enterocolitis Syndrome In the Us Populamentioning

confidence: 99%

“…The FPIES prevalence estimate of 0.51% (95% CI, 0.42-0.62) reported for US children is in line with data from the single-center population-based birth cohorts from Israel and Spain, reporting cumulative incidence of 0.34% and 0.7%, respectively. 4,5 Our study provides the first-ever estimate of FPIES prevalence in adults. To date, only several small case series of adult patients were published.…”

Section: Food Protein-induced Enterocolitis Syndrome In the Us Populamentioning

confidence: 99%

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Food protein–induced enterocolitis syndrome in the US population–based study

Nowak‐Węgrzyn

Warren

Brown‐Whitehorn

et al. 2019

Journal of Allergy and Clinical Immunology

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Section: Food Protein-induced Enterocolitis Syndrome In the Us Populamentioning

confidence: 99%

Section: Food Protein-induced Enterocolitis Syndrome In the Us Populamentioning

confidence: 99%

Food protein–induced enterocolitis syndrome in the US population–based study

Nowak‐Węgrzyn

Warren

Brown‐Whitehorn

et al. 2019

Journal of Allergy and Clinical Immunology

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“…However, the latter study may have underestimated the incidence of FPIES, because it relied on a voluntary reporting system from pediatricians, and only included cases of acute FPIES. In cow's milk-induced FPIES specifically, two independent studies conducted in Israel and Spain have both found comparable cumulative incidences in children during the first 2-3 years of life (0.34% and 0.35%, respectively) [19,20]. Similarly, the latest prevalence studies have estimated that 0.51% of children and 0.22% of adults in the United States report having physician-diagnosed FPIES [22].…”

Section: Epidemiologymentioning

confidence: 95%

“…While FPIES is also usually regarded as a rare disease, recent reports challenged this notion, revealing a cumulative incidence of 0.3-0.7% in infancy [19,20], although a lower incidence of 0.015% cases per year was also reported in Australia [21]. However, the latter study may have underestimated the incidence of FPIES, because it relied on a voluntary reporting system from pediatricians, and only included cases of acute FPIES.…”

Section: Epidemiologymentioning

confidence: 99%

“…Rice is the most commonly reported solid trigger in the United States and Australia, and may be associated with a more severe phenotype [63,[97][98][99]. Furthermore, other geographical variations are evident, such as the high prevalence of soy-induced FPIES in the United States [23,25,26,65,95], and of fish and shellfish reactions in Italy and Spain [20,40,60,76,100,101]. These are likely influenced by local dietary practices and may be the result of differences in genetic background [102].…”

Section: Reported Food Triggersmentioning

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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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 protein–induced enterocolitis syndrome: Increased prevalence of this great unknown—results of the PREVALE study

Cited by 78 publications

References 7 publications

Food protein–induced enterocolitis syndrome in the US population–based study

Food protein–induced enterocolitis syndrome in the US population–based study

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

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

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