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Related Experiment Video

Updated: Jun 14, 2025

Assessment of Social Transmission of Food Preferences Behaviors
04:56

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Published on: January 25, 2018

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Adults with FPIES may face delayed diagnoses.

Alexandra Hua1, Ian F Slack2,3, Kelly O'Shea2,3

  • 1Department of Internal Medicine, University of Michigan, Ann Arbor, Mich.

The Journal of Allergy and Clinical Immunology. Global
|August 30, 2024
PubMed
Summary

Adults with Food Protein-Induced Enterocolitis Syndrome (FPIES) experience a significant diagnostic delay, with a median of 10 years between symptom onset and diagnosis. This delay is linked to underrecognition and potential masking by comorbid gastrointestinal conditions.

Keywords:
FPIESFood protein–induced enterocolitis syndromeadult FPIESfood allergyoral food challenge

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Area of Science:

  • Allergy and Immunology
  • Gastroenterology
  • Pediatric and Adult Medicine

Background:

  • Food Protein-Induced Enterocolitis Syndrome (FPIES) is increasingly recognized in adults as a non-IgE-mediated food allergy.
  • The diagnostic latency, or the time between symptom onset and diagnosis, in adult FPIES cases is not well understood.

Purpose of the Study:

  • To investigate the time gap (latency) between age at symptom onset (ASO) and age at diagnosis (AD) in adult FPIES patients.
  • To evaluate if earlier symptom onset or comorbid gastrointestinal (GI) disease influences this latency.

Main Methods:

  • Retrospective chart review of adult FPIES patients (≥18 years) diagnosed between 2015-2022.
  • Data collected included patient demographics, FPIES reaction history, and comorbid GI conditions.
  • Statistical analysis to determine the significance of latency and its correlation with onset year and GI disease.

Main Results:

  • The median latency between ASO and AD was 10 years (P = .003).
  • A strong negative correlation (-0.99) was observed between the year of symptom onset and latency (P < .0001), indicating shorter delays in recent years.
  • Patients with pre-existing GI conditions showed a trend towards longer latency, though not statistically significant (P = .124).

Conclusions:

  • A significant diagnostic delay exists for adult FPIES, suggesting historical underrecognition.
  • The decreasing latency over time may reflect increased awareness of adult FPIES.
  • Comorbid GI conditions might mask FPIES symptoms, contributing to delayed diagnosis in adults.