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Food Induced Gastroenterocolitis Syndrome(FPIES): A Case Series of 51 Children

      Rationale

      FPIES is a non IgE mediated gastrointestinal food hypersensitivity whose clinical features are severe vomiting, diarrhea and dehydration within a few hours of ingesting food. The foods most frequently implicated in published series are cow's milk, soy, rice, fish.

      Methods

      A retrospective study of 51 patients, diagnosed by history and/or oral challenge test between 2006 and 2014.

      Results

      51 patients, 31 boys and 20 girls (mean age at diagnosis: 12.7 months) were included. The offending foods were fish(27 patients), milk(10), egg(7), beef(3), chicken(1), lentil(1), peanut(1) and chickpeas(1). The most frequent symptoms were vomiting (49 patients), letargy(18), dehydratation(12) and diarrhea(10). 20 patients have other atopic diseases, Skin prick tests y/or specific IgE against implicated food were positive in only one patient . In 12 patients, patch tests were conducted and were positive in 2 cases. 37 oral challenges test were performed in 27 patients 12 or more month after diagnosis We found that no patient outgrew FPIES by fish by 2 years of age, 44% by 3 years, 66% by 6 years and 88% by 8 years of age. By contrast 80% of FPIES by milk recovered by the age of 2 years and 100% at 3 years old. In case of egg, all patients recovered by 4 years old.

      Conclusions

      This is one of the largest series published of FPIES. It seems to be an increase in prevalence of this syndrome. The most frequent culprit food is fish with an elder age of achieved tolerance compared to other foods.