Food protein–induced enterocolitis syndrome in Australia: a population-based study, 2012-2014

Sam Mehr, Katie Frith, Elizabeth H. Barnes, Dianne E. Campbell, FPIES Study Group

Research output: Contribution to journalArticlepeer-review

68 Citations (Scopus)

Abstract

Background: Food protein–induced enterocolitis syndrome (FPIES) is a non–IgE-mediated gastrointestinal allergic disorder. Large population-based FPIES studies are lacking. Objective: We sought to determine the incidence and clinical characteristics of FPIES in Australian infants. Methods: An Australia-wide survey (2012-2014) was undertaken through the Australian Paediatric Surveillance Unit, with monthly notification of new cases of acute FPIES in infants aged less than 24 months by 1400 participating pediatricians. Results: Two hundred thirty infants with FPIES were identified. The incidence of FPIES in Australian infants (<24 months) was 15.4/100,000/y. Median age of first episode, diagnosis, and notification were 5, 7, and 10 months, respectively. There was no sex predilection. Seven percent of infants had siblings with a history of FPIES, and 5% reacted during exclusive breast-feeding. Sixty-eight had a single food trigger (20% had 2 and 12% had ≥3 food triggers). The most common FPIES triggers were rice (45%), cow's milk (33%), and egg (12%). Fifty-one percent of infants reacted on their first known exposure. Infants with FPIES to multiple versus single food groups were younger at the initial episode (4.6 vs 5.8 months [mean], P =.001) and more frequently had FPIES to fruits, vegetables, or both (66% vs 21%, P <.0001). Infants exclusively breast-fed for more than 4 months had a trend toward lower rates of FPIES to multiple food groups (23% vs 36%, P =.06). Sixty-four percent of infants with FPIES to multiple foods, which included cow's milk, had coassociated FPIES to solid foods. Forty-two percent of infants with FPIES to fish reacted to other food groups. Conclusions: FPIES is not rare, with an estimated incidence of 15.4/100,000/y. Rice is the most common food trigger in Australia. Factors associated with FPIES to multiple foods included early-onset disease and FPIES to fruits, vegetables, or both.

Original languageEnglish
Pages (from-to)1323-1330
Number of pages8
JournalJournal of Allergy and Clinical Immunology
Volume140
Issue number5
DOIs
Publication statusPublished - 1 Nov 2017
Externally publishedYes

Keywords

  • allergy
  • epidemiology
  • Food protein–induced enterocolitis syndrome
  • incidence
  • infants

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