Clinical features of food protein-induced enterocolitis syndrome
Clinical features of food protein-induced enterocolitis syndrome
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DOI：
10.1016/s0022-3476(98)70222-7
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发表时间：
1998-08-01
影响因子：
5.1
通讯作者：
Sampson, HA
中科院分区：
文献类型：
--
作者：
Sicherer, SH;Eigenmann, PA;Sampson, HA
目的：描述食物蛋白性小肠结肠炎综合征（FPIES）的临床特征，这是一种婴儿在摄入特定食物蛋白数小时后出现严重呕吐和腹泻的症状复合物。研究设计：对转诊人群进行回顾性分析。结果：典型FPIES 16例；11个与牛奶反应，11个与大豆反应，7个与两者都反应。牛奶反应性的平均诊断年龄为7周，大豆反应性的平均诊断年龄为8周。两名患者也有水稻和豌豆诱发的非典型卵巢囊肿。14例患者中位随访时间为25个月，10例患者中有6例对牛奶失去敏感性，8例患者中有2例对大豆失去敏感性。另有6例非典型病例：1例为由家禽引起的迟发性疾病，5例出现对牛奶或大豆的IgE抗体。在以牛奶和大豆为食物的监督下，外周血中性粒细胞计数在10次阳性挑战中有9次超过3500细胞/毫米(3)，而在7次阴性挑战中没有高于这一数值。62%的挑战需要紧急治疗。结论：尽管大多数FPIES患者是对牛奶和/或大豆有反应的婴儿，但在年龄较大的儿童和其他食物中应考虑这种诊断。某些患者可能会出现食物特异性IgE敏感性。标准化的食物挑战有助于诊断和随访。
Objective: To describe the clinical characteristics of food protein-induced enterocolitis syndrome (FPIES), a symptom complex of severe vomiting and diarrhea occurring several hours after the ingestion of particular food proteins in infants.Study design: Retrospective review of a referral population.Results: Sixteen patients had typical FPIES; 11 reacted to milk, 11 to soy, and 7 to both. Mean age at diagnosis was 7 weeks for milk reactivity and 8 weeks for soy reactivity. Two patients also had rice- and pea-induced FPIES. Among 14 patients who were followed up for a median period of 25 months, loss of sensitivity to milk occurred in 6 of 10 patients and loss of sensitivity to soy occurred in 2 of 8. Six additional cases of FPIES were considered atypical: 1 patient had late-onset disease caused by poultry, and in 5 patients IgE antibody to milk or soy developed. During supervised food challenges with milk and soy, the peripheral blood neutrophil count rose over 3500 cells/mm(3) in 9 of 10 positive challenges and did not rise above this value in the 7 negative challenges. Emergency treatment was required in 62% of challenges.Conclusions: Although most patients with FPIES are infants reactive to milk and/or soy, this diagnosis should be considered in older children and for other foods. Food-specific IgE sensitivity may develop in some patients. Standardized food challenges are helpful for diagnosis and follow-up.