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Food protein-induced enterocolitis syndrome in children: A swiss prospective multicenter study

Reto Villiger1, Alena Kuhn2,3, Peter Eng4

  • 1Department of Paediatrics, Hospital Center of Biel, Biel, Switzerland.

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|January 12, 2026
PubMed

Insights

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy. This study in Swiss children found acute FPIES to single foods most common, with tolerance development varying by trigger food and clinical presentation.

Area of Science:

  • Pediatric Allergy and Immunology
  • Gastroenterology
  • Clinical Nutrition

Background:

  • Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by gastrointestinal symptoms.
  • Understanding FPIES phenotypes and outcomes is crucial for effective management in children.

Purpose of the Study:

  • To analyze the diverse clinical phenotypes of FPIES in a Swiss pediatric cohort.
  • To investigate the outcomes and tolerance development associated with different FPIES presentations.

Main Methods:

  • A prospective observational study was conducted across four Swiss pediatric clinics between 2019 and 2024.
  • Ninety-eight children with a total of 121 FPIES diagnoses were enrolled.

Main Results:

  • The most frequent phenotype was acute FPIES to a single food (71%), with cow's milk, hen's egg, and fish being common triggers.
  • Chronic FPIES occurred in 14% of cases. A subset showed a phenotype switch to IgE-mediated allergy, particularly with cow's milk.
  • Median age of resolution varied: 11 months for chronic FPIES and 4.8 years for acute FPIES, with significant differences based on trigger foods.

Conclusions:

  • Acute FPIES to a single food is the predominant presentation in Swiss children.
  • Tolerance development in FPIES is influenced by the specific trigger foods and the clinical phenotype observed.
  • FPIES management and prognosis are linked to distinct clinical characteristics and food triggers.
Abstract

Keywords:
FPIES with IgE‐mediated reactionschronic FPIESfood protein‐induced enterocolitis syndromephenotype switch

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