Different Patterns of Foods Triggering FPIES in Germany

Area of Science:

• Pediatric Allergy and Immunology
• Gastroenterology
• Clinical Nutrition

Background:

• Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food allergy primarily affecting infants and young children.
• FPIES reactions differ clinically and in terms of triggers from IgE-mediated food allergies.

Purpose of the Study:

• To identify common causative food agents in German children diagnosed with FPIES.
• To investigate the development of tolerance to trigger foods in children with FPIES.

Main Methods:

• A retrospective survey was conducted across 14 German centers over a 6-year period.
• Data were collected from 142 patients experiencing 190 FPIES reactions, categorized as acute or chronic.

Main Results:

• Cow's milk was the most frequent trigger for acute FPIES, followed by fish, vegetables, meats, and grains.
• Of 152 patients, 14% showed IgE sensitization to the triggering food; 7% reacted to four or more foods.
• Time to tolerance was shortest for cow's milk-induced FPIES and shorter in chronic compared to acute FPIES.

Conclusions:

• Triggers for acute FPIES in Germany partially differ from international reports, with early-introduced infant foods being common.
• The time to develop tolerance is dependent on FPIES symptomatology and the specific triggering food.
• Findings offer insights for nutritional guidance in infants diagnosed with FPIES.