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).