Participants
Seven patients with acute FPIES who were referred to Yamaguchi University Hospital, Mine City Hospital, or Oita University Hospital between March 2008 and September 2019 were enrolled in our study (Table 1 ). The patients were diagnosed according to the criteria for acute FPIES.6 An OFC test was performed in three patients for diagnosis. The other four patients, in whom OFC tests were not performed, were diagnosed based on episodes fulfilling the criteria for acute FPIES after the ingestion of offensive food. Four patients presented cow milk (CM)-induced FPIES, two patients presented egg yolk-induced FPIES, and one presented wheat-induced FPIES. CM-, egg yolk-, or wheat-specific IgE (sIgE) were absent in all patients. There was one low birth weight and preterm infant. In the FPIES-resolved patient, the condition was induced by egg yolk.
Six patients with infectious enterocolitis [median age, 15 months; range, 3 months to 3 years (36 months)] and nine patients with IgE-mediated food allergy and anaphylaxis [median age, 60 months; range, 8 months to 8 years (99 months)] were enrolled. The infectious enterocolitis group included patients with abdominal symptoms (e.g. , vomiting, diarrhea, and bloody stool). Pathogens were identified by stool examination in all patients; norovirus and rotavirus were detected in 2 and 4 patients, respectively. Diagnosis of anaphylaxis was based on the Japanese Guidelines for Food Allergy 2014.8 Milk, egg, wheat, and buckwheat were the causative food in four, three, one, and one patient with IgE-mediated anaphylaxis, respectively. Informed consent was obtained from the parents and/or patients. The protocol was approved by the Institutional Review Board of Yamaguchi University Hospital (H28- 027).