Prolonged FPIES in children linked to detectable IgE in cow's milk

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New research shows that food protein-induced enterocolitis syndrome (FPIES) may be prolonged by detectable IgE specific to cow's milk. IgE (Immunoglobulin E) is an antibody that binds to allergens and triggers inflammation.

The results found that cow's milk, soy, rice and grains were common causes for reaction, with most patients being atopic and about 35 percent reacting to more than one food.

Forty-one percent of children with positive specific IgE levels to cow's milk evolved from milk FPIES to an IgE-mediated phenotype during the study. Tolerance was usually between 4-7 years for rice, oat, and soy while no patients with milk-specific IgE became tolerant during the study.

"FPIES is an underrecognized non-IgE-mediated food allergy that most commonly affects infants and is usually caused by cow’s milk, soy, rice and oat," the researchers concluded.

"Our data suggest that introduction of milk formula, soy formula, or both within the first weeks of life is an important risk factor for development of FPIES to milk, soy or both. a Subjects with milk and soy FPIES, as well as those with detectable food-specific IgE, might have a more protracted course [beyond aged 5 years]."

The study involved 160 patients aged 6 months to 45 years using oral food challenges to diagnose FPIES.

Study: Clinical features and resolution of food protein-induced enterocolitis syndrome: 10-year experience

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