Food protein-induced enterocolitis syndrome in adulthood: clinical characteristics, prognosis and risk factors.
Por:
González-Delgado P, Muriel J, Jiménez T, Cameo JI, Palazón-Bru A and Fernández J
Publicada:
1 sep 2022
Ahead of Print:
19 may 2022
Resumen:
BACKGROUND: Food protein-induced enterocolitis syndrome (FPIES) in adults is being increasingly recognized; however, little is known about its characteristics. OBJECTIVE: To describe the clinical characteristics, prognosis, and associated factors in adult FPIES. METHODS: A 10-year prospective study was conducted in the Allergy Section of Alicante General Hospital in adults diagnosed with FPIES. Detailed interviews with patients and oral food challenges (OFCs) were performed to confirm diagnosis or evaluate for tolerance. Comorbidities and possible risk factors were analyzed retrospectively through electronical medical records to assess their association with the disease. RESULTS: One hundred and seven adults with FPIES (93.5% female) were followed for a median of 6.2 years. Abdominal pain was the most common manifestation (96.3%), followed by diarrhea (72%) and vomiting (60.7%). Seafood (59.8%), egg (14%), and milk (10.3%) were the most common triggers, while 43.9% reacted to more than one food group. We performed 49 OFCs: 9 to confirm diagnosis and 40 to evaluate for tolerance. After a median 3.5 years, 16.8% achieved tolerance. Resolution was correlated inversely with duration of the disease (p=0.04) and seafood (p=0.023) but not with age of onset. The prevalence of gastrointestinal pathologies like irritable bowel syndrome (IBS), eosinophilic esophagitis, inflammatory bowel disease and celiac disease was higher than in the general population. A higher number of FPIES triggers was correlated with also having a diagnosis of IBS (p=0.02). CONCLUSIONS: Although adult FPIES normally persists, some patients achieve tolerance. Adults with FPIES have a relatively high prevalence of gastrointestinal pathologies. The predominance of women may be related to hormonal factors. The clinical differences with pediatric FPIES warrant a revision of diagnostic criteria in adults.
Filiaciones:
:
Allergy Service, Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
Clinical Medicine Department, University Miguel Hernández, San Juan, Alicante, Spain
:
Clinical Medicine Department, University Miguel Hernández, San Juan, Alicante, Spain
:
Allergy Service, Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
:
Gastroenterology Service. Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
:
Clinical Medicine Department, University Miguel Hernández, San Juan, Alicante, Spain
:
Allergy Service, Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
Clinical Medicine Department, University Miguel Hernández, San Juan, Alicante, Spain. Electronic address:
FULL TEXT
 |
Published Version |
|
| No Accesible |
|