Juan J Díaz1, Beatriz Espín2, Oscar Segarra3, Gloria Domínguez-Ortega4, Javier Blasco-Alonso5, Beatriz Cano6, Ana Rayo7, Ana Moreno8. 1. Hospital Universitario Central de Asturias, Oviedo. 2. Hospital Infantil Virgen del Rocío, Sevilla. 3. Hospital Universitario Vall de Hebrón, Barcelona. 4. Hospital Universitario Niño Jesús, Madrid. 5. Hospital Regional Universitario de Málaga. 6. Hospital Universitario Puerta de Hierro, Madrid. 7. Hospital Severo Ochoa, Leganés. 8. Complejo Hospitalario Universitario, A Coruña, Spain.
Abstract
OBJECTIVE: The aim of the study was to describe clinical, epidemiological, and management characteristics of food protein-induced enterocolitis syndrome (FPIES) cases in Spain. PATIENTS AND METHODS: Multicenter observational retrospective study. FPIES cases diagnosed in specialized units in Spain over 12 months in 2017 (January-December) according to the recently published international diagnostic criteria were included. RESULTS: One hundred twenty patients (53.3% boys) were included. The majority were acute cases (111) with mild-to-moderate severity (76.7%). Triggering foods were cow's milk (48/120), fish (38), egg (13), rice (12), and soy (1). The majority (84.2%) of the patients had FPIES to 1 food only. In addition to vomiting (100%), pallor (89.2%), and altered behavior (88.3%) were most frequently observed in acute forms. On the contrary, diarrhea (70%), abdominal distension (33.3%), and blood in stools (44.4%) were more frequently observed in chronic cases. Oral challenge was performed in 18.9% of the acute forms compared to 44.4% of the chronic forms. The most common treatment was intravenous fluids followed by ondansetron. Corticosteroids were used in 6 patients (5 with acute symptoms and 1 chronic). Seven patients were treated with antibiotics for suspicion of infection. Most cases of cow's milk FPIES were treated with extensively hydrolyzed formulas (69.8%). CONCLUSIONS: FPIES is not uncommon in our units. Unlike other published series, fish and egg are important triggers in our country. A greater knowledge and diffusion of the international consensus criteria will allow a better characterization of the cases and a standardization of their management.
OBJECTIVE: The aim of the study was to describe clinical, epidemiological, and management characteristics of food protein-induced enterocolitis syndrome (FPIES) cases in Spain. PATIENTS AND METHODS: Multicenter observational retrospective study. FPIES cases diagnosed in specialized units in Spain over 12 months in 2017 (January-December) according to the recently published international diagnostic criteria were included. RESULTS: One hundred twenty patients (53.3% boys) were included. The majority were acute cases (111) with mild-to-moderate severity (76.7%). Triggering foods were cow's milk (48/120), fish (38), egg (13), rice (12), and soy (1). The majority (84.2%) of the patients had FPIES to 1 food only. In addition to vomiting (100%), pallor (89.2%), and altered behavior (88.3%) were most frequently observed in acute forms. On the contrary, diarrhea (70%), abdominal distension (33.3%), and blood in stools (44.4%) were more frequently observed in chronic cases. Oral challenge was performed in 18.9% of the acute forms compared to 44.4% of the chronic forms. The most common treatment was intravenous fluids followed by ondansetron. Corticosteroids were used in 6 patients (5 with acute symptoms and 1 chronic). Seven patients were treated with antibiotics for suspicion of infection. Most cases of cow's milk FPIES were treated with extensively hydrolyzed formulas (69.8%). CONCLUSIONS: FPIES is not uncommon in our units. Unlike other published series, fish and egg are important triggers in our country. A greater knowledge and diffusion of the international consensus criteria will allow a better characterization of the cases and a standardization of their management.
Authors: Michelle C Maciag; Lisa M Bartnikas; Scott H Sicherer; Linda J Herbert; Michael C Young; Fallon Matney; Amity A Westcott-Chavez; Carter R Petty; Wanda Phipatanakul; Theresa A Bingemann Journal: J Allergy Clin Immunol Pract Date: 2020-01-28
Authors: Lisa M Bartnikas; Anna Nowak-Wegrzyn; Fallon Schultz; Wanda Phipatanakul; Theresa A Bingemann Journal: Ann Allergy Asthma Immunol Date: 2021-01-12 Impact factor: 6.347