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Food protein-induced enterocolitis syndrome: a large French multicentric experience
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  • Anaïs Lemoine,
  • Anne-Sophie Colas,
  • Sebastien LE,
  • Christophe Delacourt,
  • Patrick Tounian,
  • Guillaume LEZMI
Anaïs Lemoine
AP-HP, Trousseau Hospital
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Anne-Sophie Colas
AP-HP, Trousseau Hospital
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Sebastien LE
AP-HP, Hôpital Necker-Enfants Malades
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Christophe Delacourt
AP-HP, Hôpital Necker-Enfants Malades
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Patrick Tounian
AP-HP, Trousseau Hospital
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Guillaume LEZMI
AP-HP, Hôpital Necker-Enfants Malades
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Abstract

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, onset symptoms, and age of tolerance depending on the country of origin. We aimed to describe the characteristics of a French population of children with FPIES. Methods Data from 179 children who were referred for acute or chronic 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. 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 versus 2.0, p=0.01). Severe acute FPIES was a risk factor for delayed resolution (relative risk: 3.3 [1.2-9.2]), but not IgE sensitization. Performing an oral food challenge within 12 months after the first reaction increased the risk of failure (RR: 2.0 [1.2-3.5]). 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.

Peer review status:UNDER REVIEW

15 Apr 2021Submitted to Pediatric Allergy and Immunology
20 Apr 2021Reviewer(s) Assigned
04 May 2021Review(s) Completed, Editorial Evaluation Pending