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Characteristics of children with food protein-induced enterocolitis and allergic proctocolitis
Insights
Food protein-induced allergic proctocolitis (FPIAP) and food protein-induced enterocolitis syndrome (FPIES) share cow's milk as a common trigger, with FPIAP presenting earlier. FPIES recovery may be delayed if triggered by solid foods.
Area of Science:
- Pediatric Gastroenterology
- Allergy Immunology
Background:
- Food protein-induced enterocolitis syndrome (FPIES) and food protein-induced allergic proctocolitis (FPIAP) are distinct gastrointestinal reactions to food proteins in infants.
- Differentiating between FPIES and FPIAP is crucial for accurate diagnosis and management, yet clinical and laboratory features require further comparative analysis.
Purpose of the Study:
- To compare the clinical and laboratory features of FPIES and FPIAP.
- To evaluate the short-term prognoses of infants diagnosed with FPIES and FPIAP.
Main Methods:
- Retrospective analysis of infants diagnosed with FPIES or FPIAP between 2010 and 2015.
- Evaluation of clinical presentation, trigger foods, and short-term outcomes up to two years of age.
Main Results:
- A total of 64 infants were studied (37 FPIAP, 27 FPIES).
- FPIAP onset occurred significantly earlier (2 months) than FPIES (4 months). Cow's milk was the primary trigger for both conditions.
- Resolution rates were higher for FPIAP (91.3%) compared to FPIES (60%), with solid food-induced FPIES showing a lower recovery rate (27.3%).
Conclusions:
- Cow's milk is the most frequent trigger for both FPIAP and FPIES.
- FPIAP typically presents earlier than FPIES, and while resolution ages may be similar, FPIES triggered by solid foods has a poorer prognosis.
- This study provides the first comparative clinical analysis of FPIAP and FPIES characteristics and prognoses.
Background:
The aim of this study was to determine and compare the clinical and laboratory features of food protein-induced enterocolitis syndrome (FPIES) and food protein-induced allergic proctocolitis (FPIAP), and to provide information about the short-term prognoses.
Method:
Children diagnosed with FPIES or FPIAP between 2010 and 2015 were enrolled in this study.
Results:
Overall, 64 infants (37 FPIAP, 27 FPIES) were evaluated, with the average age at the onset of symptoms being significantly lower in the patients with FPIAP than in the patients with FPIES (2 months [1-3 months] versus 4 months [1.5-6 months]; p = 0.043). Fifteen of the patients with FPIAP (40.5%) and six of the patients with FPIES (22.2%) were exclusively breast-fed at the time of the onset of symptoms. Cow's milk was the most frequent trigger (100% FPIAP, 74% FPIES); solid foods caused FPIES more frequently. Forty-eight of the 64 patients were followed up until at least 2 years of age, with the resolution rates being 91.3% for FPIAP and 60% for FPIES. The solid food-induced cases of FPIES (27.3%) had a significantly lower rate of resolution than the liquid food-induced FPIES (83.3%) (p = 0.003).
Conclusion:
Cow's milk is the most common trigger of both FPIAP and FPIES. The symptom onset age seemed to be earlier in FPIAP. The resolution age was similar, however, the recovery in FPIES may be later if the trigger food is solid. To our knowledge, this was the first clinical study to compare the clinical and laboratory characteristics of patients with FPIAP and FPIES.
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