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Atopic Comorbidity Up in Children With Food Protein-Induced Enterocolitis

Higher rates seen for atopic dermatitis, IgE-mediated food allergy, asthma, allergic rhinitis

WEDNESDAY, March 11, 2020 (HealthDay News) — Children with food protein-induced enterocolitis syndrome (FPIES) have higher rates of atopic comorbidity, according to a study published online in the March issue of the Journal of Allergy and Clinical Immunology: In Practice.

Melanie A. Ruffner, M.D., Ph.D., from the Children’s Hospital of Philadelphia, and colleagues examined a primary care birth cohort of 158,510 pediatric patients, of whom 214 met the 2017 diagnostic criteria for FPIES. The influence of FPIES on developing subsequent atopic disease was assessed.

The researchers found that depending on birth year, the incidence of pediatric FPIES was 0.17 to 0.42 percent. Most patients had an acute presentation (78 percent), as seen in prior reports; common triggers included milk, soy, oat, rice, potato, and egg. Diagnosis occurred at a mean of 6.8 months. Compared with healthy children, patients with FPIES had higher atopic comorbidity (atopic dermatitis: 20.6 versus 11.7 percent; immunoglobulin-E-mediated food allergy: 23.8 versus 4.0 percent; asthma: 26.6 versus 18.4 percent; and allergic rhinitis: 28.0 versus 16.7 percent). Prior FPIES did not influence the rate of atopy development in a longitudinal data analysis.

“Although there is an increased rate of atopic allergies in patients with FPIES, our analyses demonstrate that a prior diagnosis of FPIES does not increase the rate of atopic allergies later in life,” a coauthor said in a statement. “This pattern of association supports a yet-unknown cause, such as a shared predisposition to both types of allergy.”

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