Introduction
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated food allergic disorder predominantly affecting infants and children. Despite a poor understand of the pathophysiology of FPIES, several large clinical cohorts have been published, and international consensus guidelines for the diagnosis have been established1.
We previously performed a prospective population-based study across Australia examining the incidence, clinical characteristics and food trigger associations for infants with FPIES 2. This demonstrated an incidence of 15.4/100,000/year in infants less than 2 years of age, suggesting that FPIES is more common than previously recognised. Other studies have demonstrated higher rates of FPIES, with Katz et al. demonstrating a cumulative incidence of 0.34% of cow’s milk FPIES in an Israeli cohort 3, and Alonso et al. demonstrating an incidence of 0.7% in a Spanish cohort4.
There is a recognised regional variation in the causative food triggers associated with FPIES, with cow’s milk, soy, rice and fish being the most common triggers 3, 5, 6. Australia is the only region to have consistently reported rice as the most common cause of FPIES. Fish FPIES is common in southern Europe, whilst most US and UK studies report cow’s milk as the most common trigger 5, 7, 8.
Here, we sought to determine the consistency of identified trends in Australian patients with FPIES by characterising the demographic profile, medical history and food trigger associations of a single tertiary centre cohort of patients collected over a 20-year period. We sought to identify risk factors associated with co-associations, severity of reaction and resolution of FPIES.