Poor prognosis of food protein-induced enterocolitis syndrom
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Fish is the most common causative food of Food Protein-Induced Enterocolitis Syndrome (FPIES) in Southern Europe. In children with FPIES, the development of tolerance varies according to the culprit food and specifically fish seems to have a poorer prognosis than other solid foods. Researchers sought to evaluate the fish-FPIES resolution rate in children.

A descriptive retrospective analysis of children with fish FPIES, followed during the last 20 years, was performed. The offending fish, age and symptoms at onset, the coexistence of atopic diseases and FPIES to other foods were registered. All the children included had undergone an oral food challenge (OFC) with the offending fish. The record was made for those children that overcame their fish-FPIES and those that did not outgrow the disease.

Results:
70 children were enrolled in this study (median age: 9 yo; IQR 6.4-13.8). (60%) achieved tolerance to the offending fish with a median age of 4 years. Among children 5yrs (n=40) 87.5% developed tolerance, among 6-8yrs (n=14) 40% developed tolerance and only 12.5% among those more than 9yrs (n=16) developed tolerance.
28 children did not outgrow the disease (median age: 8.9 yo; IQR: 9-13.8). Researchers did not find any statistical differences regarding the offending fish, presence of single versus multiple fish-FPIES, symptoms at the beginning, coexistence of other atopic diseases or the coexistence of other FPIES, between the children who overcame the disease and those who did not.

Conclusively, 1 in 5 children with FPIES to fish will not overcome the disease during childhood.

Source: https://onlinelibrary.wiley.com/doi/abs/10.1111/pai.13430?af=R
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