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Food Protein-Induced Enterocolitis Syndrome: 16-Year Experience
- Source :
- Pediatrics. 123:e459-e464
- Publication Year :
- 2009
- Publisher :
- American Academy of Pediatrics (AAP), 2009.
-
Abstract
- Objective. The goal was to examine the demographic characteristics, causative foods, clinical features, treatments, and outcomes for children presenting with acute food protein-induced enterocolitis syndrome. Methods. This was a retrospective study of children with food protein-induced enterocolitis syndrome who presented to the Children's Hospital at Westmead (Sydney, Australia) over 16 years. Results. Thirty-five children experienced 66 episodes of food protein-induced enterocolitis syndrome. The mean age at initial presentation was 5.5 months. Children frequently experienced multiple episodes before a correct diagnosis was made. Twenty-nine children reacted to 1 food, and 6 reacted to 2 foods. Causative foods for the 35 children were rice (n = 14), soy (n = 12), cow's milk (n = 7), vegetables and fruits (n = 3), meats (n = 2), oats (n = 2), and fish (n = 1). In the 66 episodes, vomiting was the most common clinical feature (100%), followed by lethargy (85%), pallor (67%), and diarrhea (24%). A temperature of 500 × 109 cells per L was recorded for 63% of episodes with blood count results. Only 2 of the 19 children who presented to an emergency department with their initial reactions were discharged with correct diagnoses. Additional investigations of food protein-induced enterocolitis syndrome episodes presenting to the hospital were common, with 34% of patients undergoing abdominal imaging, 28% undergoing a septic evaluation, and 22% having a surgical consultation. Prognosis was good, with high rates of resolution for the 2 most common food triggers (ie, rice and soy) by 3 years of age. Conclusions. Misdiagnosis and delays in diagnosis for children with food protein-induced enterocolitis syndrome were common, leading many children to undergo unnecessary, often painful investigations. Decreased body temperature and thrombocytosis emerge as additional features of the syndrome.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Meat
Adolescent
Pallor
Diagnosis, Differential
Lethargy
Recurrence
Risk Factors
medicine
Humans
Child
Retrospective Studies
Enterocolitis
Thrombocytosis
business.industry
Oryza
Immunoglobulin E
Intradermal Tests
Milk Proteins
medicine.disease
Failure to Thrive
Food protein-induced enterocolitis syndrome
Diarrhea
Child, Preschool
Pediatrics, Perinatology and Child Health
Failure to thrive
Soybean Proteins
Vomiting
Female
Dietary Proteins
medicine.symptom
business
Food Hypersensitivity
Subjects
Details
- ISSN :
- 10984275 and 00314005
- Volume :
- 123
- Database :
- OpenAIRE
- Journal :
- Pediatrics
- Accession number :
- edsair.doi.dedup.....031da716e3b82fbed0d4417bdb78ca3a