FPIES characteristics
A total of 192 FPIES cases were reported. The diagnosis of FPIES wasconfirmed in 151 cases and was presumptive in 41 cases (Table III). Children with confirmed or presumptive FPIES did not differ in terms of sex ratio, atopic status, age at tolerance or tolerance rate (Table III). Acute or recurrent chronic vomiting were present in all of the children.
Children with acute FPIES had a mean of 3.3 minor criteria (maximum: 7). The most frequent minor criteria were recurrent episodes of repetitive vomiting after eating the same culprit food (84.8%), followed by lethargy (74.5%), pallor (53,1%), the need for an emergency department visit (37.9%), diarrhea (33.1%), the need for intravenous fluid support (27.6%), vomiting after eating a different food (19.3%), and hypotension (4.1%). Hypothermia was not recorded. Lethargy, pallor, an emergency department visit, and intravenous fluid support were more often found in confirmed FPIES cases (p<0.01) (Table III).
Thirteen children (7.3%) experienced severe confirmed acute FPIES (Table III). Two patients required hospitalization in an intensive care unit owing to severe dehydration following ingestion of CM. Eleven patients needed rapid vascular filling during an OFC.
A total of 47 children (26.1%) had chronic FPIES, and CM was the only elicitor of chronic FPIES.
One hundred and sixty-nine (94.4%) children had single FPIES, and 10 (5.6%) had multiple FPIES. Twenty-three culprit foods were identified. CM was involved in 108 children (60.3%), hen’s egg in 29 (16.2%), and fish in 21 (11.7%) (Figure 1). Among the 10 multiple FPIES cases reported, CM was involved in 6 cases. One child had FPIES to 4 foods (CM, chicken, hen’s egg, and green beans), another one to 3 foods (CM, hen’s egg, maize), and 8 to 2 foods: CM and beef/veal (n=2), CM and soy, CM and raspberry, rice and hen’s egg, rice and banana, coconut and tomato, avocado and cashew nuts.