Premium
Increased C‐reactive protein and fever in Japanese infants with food protein‐induced enterocolitis syndrome
Author(s) -
Kimura Mitsuaki,
Ito Yasunori,
Tokunaga Fumika,
Meguro Takaaki,
Shimomura Masaki,
Morishita Hideaki,
Seto Shiro
Publication year - 2016
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12938
Subject(s) - medicine , enterocolitis , gastroenterology , oral food challenge , ingestion , c reactive protein , necrotizing enterocolitis , immunology , food allergy , allergy , inflammation
Background Increased C‐reactive protein (CRP) and fever are observed in some infants with food protein‐induced enterocolitis syndrome (FPIES) in Japan , but the reproducibility of these findings has not yet been confirmed on oral food challenge (OFC). Methods Fourteen infants with FPIES induced by cow's milk (CM) formula were enrolled. OFC using CM formula was performed on each infant once or repeatedly (total 18 tests), with a stepwise incremental protocol in an infection‐controlled setting. CRP was measured 24 h after the last ingestion of the CM formula. Results Increased CRP was observed in 11 of the 18 OFC conducted (median, 2.60 mg/dL; range, 0.22–4.84 mg/dL). Fever was induced in six occasions during OFC. Serum CRP in the patients with fever increased to median 3.76 mg/dL (range, <0.7–4.84 mg/dL), which was significantly higher than that of the patients without fever (median <0.1 mg/dL; range, <0.1–2.6 mg/dL; P < 0.001). CRP during OFC significantly correlated with that at disease onset (rs = 0.62, P < 0.02). Three of the four patients with fever at disease onset also had fever during OFC. Conclusions Increased CRP and fever are reproducible during OFC in some infants with FPIES, suggesting that these are not accidental phenomena, but instead are associated with FPIES itself in Japanese patients.