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    A different starting line for allergic march: food protein-induced allergic proctocolitis
    (Codon Publications, 2023) Bahceci, Semiha; Toz, Pinar Kuyum; Celik, Figen Celebi; Can, Demet
    Objective: The aim of this study is to investigate the long-term prognosis of food protein-induced allergic proctocolitis (FPIAP) patients, the risk of developing both allergic and gastrointestinal diseases, and to evaluate whether it leads to allergic march. Methods: A total of 149 children who were diagnosed with FPIAP and developed tolerance at least 5 years prior to the study and 41 children (with no history of food allergy) as a control group were enrolled. Both groups were re-evaluated for allergic diseases as well as gastrointestinal disorders. Results: The mean age of diagnosis for the FPIAP group was 4.2 +/- 3.0 months, while the mean age of tolerance was 13.9 +/- 7.7 months. The mean age of both FPIAP and control groups at the last visit was 101.6 +/- 24.4 and 96.3 +/- 24.1 months, respectively (P = 0.213). At the final evaluation of both groups, the comorbid allergic disease was significantly higher in the FPIAP group (P < 0.001). There was no significant difference between the two groups in terms of functional gastrointestinal disorders (FGIDs), eosinophilic gastrointestinal diseases, and inflammatory bowel disease (P = 0.198, 0.579, and 0.579, respectively). In the FPIAP group, the allergic disease was significantly higher at the final visit in patients with comorbid allergic disease at diagnosis (P < 0.001). In the FPIAP group, FGID was significantly higher in the group that developed allergic diseases in the future, compared to the group that did not develop allergic diseases in the future (P = 0.034). The proportion of both FGID and allergic diseases was significantly higher in subjects that developed tolerance at >18 months, compared to subjects that developed tolerance at =18 months (P < 0.001 and < 0.001, respectively). Conclusions: Patients with FPIAP may develop allergic diseases as well as FGID in the long term. (c) 2023 Codon Publications. Published by Codon Publications.
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    Evaluation of the Clinical Characteristics of Patients with Food Protein-Induced Enterocolitis Syndrome: A Multicenter Study
    (Karger, 2022) Metbulut, Azize Pinar; Ozen, Selime; Kendirci, Nergiz; Guc, Belgin Usta; Guvenir, Hakan; Vezir, Emine; Bahceci, Semiha
    Introduction: Food protein-induced enterocolitis syndrome (FPIES) is a rare non-IgE, cell-mediated food allergy disorder. We aimed to report the demographic characteristics, clinical features, and management of pediatric patients with FPIES. Methods: This retrospective study included all children diagnosed with FPIES at the pediatric allergy departments of the participating twelve study centers from January 2015 to November 2020. Results: A total of 73 patients (39 males, 53.4%) with a male/female ratio of 1.1 were included in the study. The median (interquartile ranges) age at symptom onset was 6 months (0.5-168, 4-9.5). The most frequent offending foods were cow's milk, egg's yolk, fish, and egg's white, identified in 38.4% (n = 28), 32.9% (n = 24), 21.9% (n = 16) and 20.5% (n = 15) of the patients, respectively. The total number of reported FPIES episodes was 290 (3.9 episodes per child). Oral food challenge (OFC) was performed in 54.8% (n = 40) of the patients, and tolerance was detected in 17 OFCs (42.5%) at a median age of 15 months (range 8-132 months). Conclusion: FPIES is a non-IgE-mediated food hypersensitivity that commonly affects infants and is often misdiagnosed. The pathophysiology of the disease remains unclear and the low awareness of FPIES among physicians and parents highlights the need for more education.
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    Food Protein-induced Enterocolitis Syndrome: A Single-center Experience
    (Galenos Publ House, 2023) Bahceci, Semiha; Toez, Pinar Kuyum; Ayar, Murat
    Objective: Food protein-induced enterocolitis syndrome (FPIES) is an uncommon, non-IgE (immunoglobulin E)-mediated food allergy that mainly affects infants and young children. Our study aims to evaluate the etiology, clinical phenotypes, and tolerance status of our cases with FPIES.Method: The file records of the patients who were followed up with the diagnosis of FPIES in the Departments of Pediatric Allergy and Gastroenterology of our hospital, between September 2016 and June 2022 were examined, and families who could not attend follow-up visits regularly were contacted by phone.Results: Twelve (66.6 6%) of 18 cases with a mean age of admission of 33.0 +/- 27.5 (2-108) months were boy. The triggers of FPIES were fish in 66.66%, cow's milk in 16.66%, eggs in 5.55%, eggs and milk in 5.55%, and potato in 5.55% of the patients. While 94.44% of the cases had acute FPIES, and 44.4% of them had early-onset (<9 months) FPIES. The most common symptoms were vomiting (10 0%), diarrhea (38.8 8%), pallor (27.7 7%), lethargy (22.22%). Food-specific IgE sensitization was found in 5.55% of the patients, while tolerance developed in 33.33% of the cases during the follow-up. The mean age of tolerance development was 63 +/- 42 (19-112) months.Conclusion: It is important to have knowledge about the symptoms of FPIES for accurate and early diagnosis. While cow's milk is the most prevalent triggers of FPIES in the literature, fish was at the forefront in our series. Despite the limited number of cases, our results are important in terms of giving us an idea about the triggers of FPIES in the western regions of Turkey.