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Food protein‐induced enterocolitis syndrome caused by fish and/or shellfish in I taly
Author(s) -
Miceli Sopo Stefano,
Monaco Serena,
Badina Laura,
Barni Simona,
Longo Giorgio,
Novembre Elio,
Viola Serena,
Monti Giovanna
Publication year - 2015
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12461
Subject(s) - medicine , shellfish , enterocolitis , oral food challenge , fish <actinopterygii> , pediatrics , allergy , food allergy , fishery , biology , immunology , aquatic animal
Background The study describes the demographic features, culprit foods, clinical features and outcomes for children presenting with acute fish and/or shellfish food protein‐induced enterocolitis syndrome ( FPIES ) in four I talian paediatric allergy centres. Methods A retrospective/prospective study was undertaken. All children diagnosed with fish or shellfish FPIES were enrolled. The diagnosis of FPIES was based on S icherer's or M iceli S opo clinical criteria. Skin prick tests ( SPT ) were performed in all patients, at the time of diagnosis and prior to OFC . Results Seventy children were enrolled. Mean age at first episode was 14 months (range 6–46 months); mean age at diagnosis was 34 months (range 6–164 months). Sole and cod were the fish most commonly implicated. Fifty‐seven of 70 (81%) children had FPIES exclusively to fish, 37 of 57 (65%) children had single‐fish FPIES , 20 of 57 (35%) multiple‐fish FPIES , nine of 70 (13%) presented adverse reactions exclusively to shellfish, and four of 70 (6%) presented adverse reactions to both fish and shellfish. Only four (5.7%) children presented episodes of acute FPIES with different foods (2 to cow's milk, 1 to egg, 1 to beef); in all cases, onset was prior to that of fish or shellfish FPIES . Fifteen of 70 (21%) children tolerated fish other than the offending fish. Twenty‐four of 70 (34%) children achieved tolerance (age range 24–102 months). Conclusions The chief peculiarities of acute fish and shellfish FPIES , compared to more frequent cow's milk or soy FPIES , are (i) later age of onset, (ii) longer persistence and (iii) possibility of tolerating fish other than the offending fish. Adverse reactions with shellfish are possible.