Kuan-Wen Su1, Sarita U Patil2, Jennifer L Stockbridge3, Victoria M Martin4, Yamini V Virkud2, Jing-Long Huang5, Wayne G Shreffler2, Qian Yuan6. 1. Food Allergy Center, Massachusetts General Hospital, Boston, Mass; Division of Pediatric Allergy and Immunology, Massachusetts General Hospital, Boston, Mass; Department of Pediatrics, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan. 2. Food Allergy Center, Massachusetts General Hospital, Boston, Mass; Division of Pediatric Allergy and Immunology, Massachusetts General Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass; Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Mass. 3. Food Allergy Center, Massachusetts General Hospital, Boston, Mass; Division of Pediatric Allergy and Immunology, Massachusetts General Hospital, Boston, Mass. 4. Food Allergy Center, Massachusetts General Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Massachusetts General Hospital, Boston, Mass. 5. Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: long@adm.cgmh.org.tw. 6. Food Allergy Center, Massachusetts General Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Massachusetts General Hospital, Boston, Mass. Electronic address: qyuan@mgh.harvard.edu.
Abstract
BACKGROUND: Food protein-induced enterocolitis syndrome (FPIES) is a form of non-IgE-mediated gastrointestinal food allergy. Insufficient data exist in regard to gastrointestinal history and outcome, particularly comorbidity, family history, food aversion, and poor body weight gain. OBJECTIVE: We sought to identify the gastrointestinal outcomes and related risk factors in FPIES. METHODS: We analyzed the clinical features and gastrointestinal outcomes of patients with FPIES retrospectively at 4 hospitals in Boston. RESULTS: Two hundred three patients with FPIES were identified, including 180 only with acute FPIES, 8 with chronic FPIES, and 15 with both. Oat (34.5%), rice (29.6%), and cow's milk (19.2%) were the most common food triggers. The prevalence rates of personal history with allergic proctocolitis (23.2%) and family history with inflammatory bowel diseases (9.4%) and celiac disease (7.3%) were higher than those in the general population. Compared with patients with FPIES with 1 or 2 food triggers, the risk of developing food aversion increased in cases triggered by 3 or more foods (adjusted odds ratio, 3.07; 95% CI, 1.38-6.82; P = .006). The risk of poor body weight gain increased in FPIES triggered by cow's milk (adjusted odds ratio, 3.41; 95% CI, 1.21-9.63; P = .02) and banana (adjusted odds ratio, 7.63; 95% CI, 2.10-27.80; P = .002). CONCLUSIONS: Gastrointestinal comorbidities and family history were common in patients with FPIES. Patients with FPIES with 3 or more triggers were at risk of food aversion. Patients with FPIES with cow's milk and banana as triggers were at risk of poor body weight gain.
BACKGROUND: Food protein-induced enterocolitis syndrome (FPIES) is a form of non-IgE-mediated gastrointestinal food allergy. Insufficient data exist in regard to gastrointestinal history and outcome, particularly comorbidity, family history, food aversion, and poor body weight gain. OBJECTIVE: We sought to identify the gastrointestinal outcomes and related risk factors in FPIES. METHODS: We analyzed the clinical features and gastrointestinal outcomes of patients with FPIES retrospectively at 4 hospitals in Boston. RESULTS: Two hundred three patients with FPIES were identified, including 180 only with acute FPIES, 8 with chronic FPIES, and 15 with both. Oat (34.5%), rice (29.6%), and cow's milk (19.2%) were the most common food triggers. The prevalence rates of personal history with allergic proctocolitis (23.2%) and family history with inflammatory bowel diseases (9.4%) and celiac disease (7.3%) were higher than those in the general population. Compared with patients with FPIES with 1 or 2 food triggers, the risk of developing food aversion increased in cases triggered by 3 or more foods (adjusted odds ratio, 3.07; 95% CI, 1.38-6.82; P = .006). The risk of poor body weight gain increased in FPIES triggered by cow's milk (adjusted odds ratio, 3.41; 95% CI, 1.21-9.63; P = .02) and banana (adjusted odds ratio, 7.63; 95% CI, 2.10-27.80; P = .002). CONCLUSIONS: Gastrointestinal comorbidities and family history were common in patients with FPIES. Patients with FPIES with 3 or more triggers were at risk of food aversion. Patients with FPIES with cow's milk and banana as triggers were at risk of poor body weight gain.
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
Authors: Paul J Turner; Stefania Arasi; Barbara Ballmer-Weber; Alessia Baseggio Conrado; Antoine Deschildre; Jennifer Gerdts; Susanne Halken; Antonella Muraro; Nandinee Patel; Ronald Van Ree; Debra de Silva; Margitta Worm; Torsten Zuberbier; Graham Roberts Journal: Allergy Date: 2022-04-28 Impact factor: 14.710