Recent dramatic increase in patients with food protein–induced enterocolitis syndrome (FPIES) provoked by hen’s egg in Japan

2021 ◽  
Author(s):  
Masayuki Akashi ◽  
Daisuke Hayashi ◽  
Naoki Kajita ◽  
Misako Kinoshita ◽  
Tomo Ishii ◽  
...  
Keyword(s):  
Food Protein ◽  
Hen’S Egg

Food protein-induced enterocolitis syndrome in the British Isles

2021 ◽  
pp. archdischild-2020-320924
Author(s):  
Gary Stiefel ◽  
Cherry Alviani ◽  
Nadeem A Afzal ◽  
Aideen Byrne ◽  
George du Toit ◽  
...  
Keyword(s):  
Fruits And Vegetables ◽  
Healthcare Professionals ◽  
Diagnostic Delay ◽  
Epidemiological Survey ◽  
Case Definition ◽  
Food Protein ◽  
British Isles ◽  
Common Food ◽  
Hen’S Egg ◽  
Delays In Diagnosis

BackgroundFood protein-induced enterocolitis syndrome (FPIES) is a delayed type of food allergy, most often seen in infancy. We aimed to estimate its incidence, to describe common food triggers and the patient journeys of this rare but serious condition.DesignWe undertook a prospective epidemiological survey of FPIES using the British Paediatric Surveillance Unit.SettingUK and Ireland.ParticipantsA survey of all paediatricians over 13 months between January 2019 and February 2020.Main outcome measures204 cases were reported, 98 (48%) meeting case definition, giving an incidence of 0.006% for England based on 93 cases.Results98 patients reported 135 trigger foods, 27% (26 of 98) had multiple food triggers. Common food triggers included cow’s milk (24%, 33 of 135), fruits and vegetables (19%, 26 of 135), hen’s egg (16%, 22 of 135) and fish (14%, 19 of 135). In 46% (41 of 90), the initial trigger food had been ingested three or more times before diagnosis, with a median diagnostic delay of 7.9 months (3.0, 17.3). Half (50 of 98) were admitted, yet only 5% (5 of 98) received appropriate acute treatment with ondansetron. Most cases were diagnosed by an allergy specialist (74 of 98, 76%), within a median of 7.5 (3.0, 13.3) miles from home.ConclusionThe incidence of FPIES was significantly lower than expected across the whole of the British Isles. Most reports were of cases local to specialist allergy centres, with delays in diagnosis. This suggests under-recognition of FPIES in frontline clinical setting where education of healthcare professionals is required to improve recognition, earlier diagnosis and treatment.

Food protein–induced enterocolitis to hen’s egg

2011 ◽  
Vol 128 (6) ◽  
pp. 1386-1388 ◽  
Author(s):  
Jean-Christoph Caubet ◽  
Anna Nowak-Węgrzyn
Keyword(s):  
Food Protein ◽  
Hen’S Egg

Phenotypes and natural history of food protein‐induced enterocolitis syndrome in the east Mediterranean region

2020 ◽  
Vol 41 (6) ◽  
pp. 420-427 ◽  
Author(s):  
Melike Ocak ◽  
Ayşegül Akarsu ◽  
Umit Murat Sahiner ◽  
Ozge Soyer ◽  
Bulent Enis Sekerel
Keyword(s):  
Clinical Symptoms ◽  
Emergency Department Visits ◽  
Interquartile Range ◽  
Cow’S Milk ◽  
Food Protein ◽  
Cow's Milk ◽  
Hen’S Egg ◽  
History Of ◽  
Ige Mediated ◽  
East Mediterranean Region

Background: Food protein‐induced enterocolitis syndrome (FPIES) is a rare non-IgE mediated food allergy. Objective: To delineate the differences in the spectrum of culprit foods, remission patterns, and predictors among varying cultures. Methods: We reviewed demographics, culprit foods, outcomes, and predictors in 81 children with a diagnosis of FPIES who were followed up between 2015 and 2020. Results: Eighty-one patients (55.6% boys) were enrolled, including 72 with acute FPIES and 9 with chronic FPIES. Hen’s egg was the most common culprit food (36.6%), followed by fish (26.9%), and cow’s milk (21.5%). Interestingly, cow’s milk was significantly prevalent in chronic FPIES cases (p = 0.006). The most common clinical symptoms were vomiting (100%), pallor (63.4%), and lethargy (55.9%). Emergency department visits were noted in 39 patients (41.9%), of whom 37 (39.8%) were treated with intravenous (IV) fluid. The subjects were followed up for a median (interquartile range) of 19.4 months (12.3‐41.2 months), and 26 subjects (32.1%) achieved tolerance. The median (interquartile range) age at tolerance was 2.5 years (2.1‐3.2 years). With regard to the culprit foods, hen’s egg was observed more frequently in the subjects with resolved FPIES cases (p = 0.008), whereas fish FPIES cases were high in the persistent group (p = 0.001). IgE sensitization of the culprit food was found to be an independent risk factor for the persistence of FPIES (odds ratio 4.855 [95% confidence interval, 1.131‐20.844]; p = 0.034). Conclusion: In our cohort, unlike other published series, hen’s egg and fish were the two most common culprit foods. Fish differed from other culprit foods, with significantly delayed onset and persistence, and may create a model that allows for the understanding of the disease.

scholarly journals Detection and Quantification of Allergens in Foods and Minimum Eliciting Doses in Food-Allergic Individuals (ThRAll)

2019 ◽  
Vol 102 (5) ◽  
pp. 1346-1353 ◽  
Author(s):  
E N Clare Mills ◽  
Karine Adel-Patient ◽  
Hervé Bernard ◽  
Marc De Loose ◽  
Nathalie Gillard ◽  
...  
Keyword(s):  
Reference Method ◽  
Quality Data ◽  
Food Protein ◽  
Processed Food ◽  
Hen’S Egg ◽  
Data Gaps ◽  
Food Matrices ◽  
Food Challenges ◽  
Analytical Tools ◽  
Good Quality Data

Abstract Risk-based approaches to managing allergens in foods are being developed by the food industry and regulatory authorities to support food-allergic consumers to avoid ingestion of their problem food, especially in relation to the traces of unintended allergens. The application of such approaches requires access to good quality data from clinical studies to support identification of levels of allergens in foods that are generally safe for most food-allergic consumers as well as analytical tools that are able to quantify allergenic food protein. The ThRAll project aims to support the application of risk-based approaches to food-allergen management in two ways. First, a harmonized quantitative MS-based prototype reference method will be developed for the detection of multiple food allergens in standardized incurred food matrices. This will be undertaken for cow’s milk, hen’s egg, peanut, soybean, hazelnut, and almond incurred into two highly processed food matrices, chocolate and broth powder. This activity is complemented by a second objective to support the development and curation of data on oral food challenges, which are used to define thresholds and minimum eliciting doses. This will be achieved through the development of common protocols for collection and curation of data that will be applied to allergenic foods for which there are currently data gaps.

scholarly journals Analysis of 10 cases of food protein-induced enterocolitis syndrome due to hen's egg

2020 ◽  
Vol 13 (8) ◽  
pp. 100410
Author(s):  
Makoto Nishino ◽  
Noriyuki Yanagida ◽  
Sakura Sato ◽  
Motohiro Ebisawa
Keyword(s):  
Food Protein ◽  
Hen’S Egg

scholarly journals Food protein-induced enterocolitis syndrome: a large French multicentric experience

2021 ◽  
Author(s):  
Anaïs Lemoine ◽  
Anne-Sophie Colas ◽  
Sebastien LE ◽  
Christophe Delacourt ◽  
Patrick Tounian ◽  
...  
Keyword(s):  
Food Challenge ◽  
Good Prognosis ◽  
Food Protein ◽  
Consensus Guidelines ◽  
International Consensus ◽  
Hen’S Egg ◽  
Main Culprit ◽  
Ige Mediated ◽  
International Consensus Guidelines ◽  
French Cohort

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.

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