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.