PT  - JOURNAL ARTICLE
AU  - Gary Stiefel
AU  - Cherry Alviani
AU  - Nadeem A Afzal
AU  - Aideen Byrne
AU  - George du Toit
AU  - Audrey DunnGalvin
AU  - Jonathan Hourihane
AU  - Nicola Jay
AU  - Louise Jane Michaelis
AU  - Michel Erlewyn-Lajeunesse
TI  - Food protein-induced enterocolitis syndrome in the British Isles
AID  - 10.1136/archdischild-2020-320924
DP  - 2021 Aug 26
TA  - Archives of Disease in Childhood
PG  - archdischild-2020-320924
4099  - http://adc.bmj.com/content/early/2021/08/25/archdischild-2020-320924.short
4100  - http://adc.bmj.com/content/early/2021/08/25/archdischild-2020-320924.full
AB  - Background Food protein-induced enterocolitis syndrome (FPIES) is a delayed type of food allergy, most often seen in infancy. We aimed to estimate its incidence, to describe common food triggers and the patient journeys of this rare but serious condition.Design We undertook a prospective epidemiological survey of FPIES using the British Paediatric Surveillance Unit.Setting UK and Ireland.Participants A survey of all paediatricians over 13 months between January 2019 and February 2020.Main outcome measures 204 cases were reported, 98 (48%) meeting case definition, giving an incidence of 0.006% for England based on 93 cases.Results 98 patients reported 135 trigger foods, 27% (26 of 98) had multiple food triggers. Common food triggers included cow’s milk (24%, 33 of 135), fruits and vegetables (19%, 26 of 135), hen’s egg (16%, 22 of 135) and fish (14%, 19 of 135). In 46% (41 of 90), the initial trigger food had been ingested three or more times before diagnosis, with a median diagnostic delay of 7.9 months (3.0, 17.3). Half (50 of 98) were admitted, yet only 5% (5 of 98) received appropriate acute treatment with ondansetron. Most cases were diagnosed by an allergy specialist (74 of 98, 76%), within a median of 7.5 (3.0, 13.3) miles from home.Conclusion The incidence of FPIES was significantly lower than expected across the whole of the British Isles. Most reports were of cases local to specialist allergy centres, with delays in diagnosis. This suggests under-recognition of FPIES in frontline clinical setting where education of healthcare professionals is required to improve recognition, earlier diagnosis and treatment.No data are available.