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Cooking influence in tolerance acquisition in egg-induced acute food protein enterocolitis syndrome
Authors:S Miceli Sopo  A Romano  G Bersani  C Fantacci  L Badina  G Longo  G Monti  S Viola  S Tripodi  G Barilaro  ID Iacono  C Caffarelli  C Mastrorilli  S Barni  F Mori  L Liotti  B Cuomo  F Franceschini  S Monaco
Institution:1. Allergy Unit, Pediatrics Area, Department of Woman and Child Health, Università Cattolica del Sacro Cuore, Policlinico Gemelli Foundation, Rome, Italy;2. Allergy Unit, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy;3. Allergy Unit, Department of Pediatrics and Adolescence Science, Regina Margherita Children''s Hospital, Turin, Italy;4. Department of Pediatrics and Unit of Pediatric Allergology, Sandro Pertini Hospital, Rome, Italy;5. Allergy Unit, Fatebenefratelli Hospital, Benevento, Italy;6. Allergy Unit, Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy;7. Allergy Unit, Department of Pediatrics, Anna Meyer Children''s University Hospital, Florence, Italy;8. Allergy Unit, Pediatric Clinic, Ospedale Civile Senigallia, Senigallia, Italy;9. Allergy Unit, Pediatric Clinic, Belcolle Hospital, Viterbo, Italy;10. Allergy Unit, Department of Pediatrics, University Hospital, Ancona, Italy;11. Primary Care Pediatrics, ASL Salerno, Cava de’ Tirreni, Italy
Abstract:

Background

Few studies on the age of resolution of Food Protein Induced Enterocolitis Syndrome (FPIES) induced by solid foods are available. In particular, for FPIES induced by egg, the mean age of tolerance acquisition reported in the literature ranges from 42 to 63 months.

Objective

We have assessed whether the age of tolerance acquisition in acute egg FPIES varies depending on whether the egg is cooked or raw.

Methods

We conducted a retrospective and multicentric study of children with diagnosis of acute egg FPIES seen in 10 Italian allergy units between July 2003 and October 2017. The collected data regarded sex, presence of other allergic diseases, age of onset of symptoms, kind and severity of symptoms, cooking technique of the ingested egg, outcome of the allergy test, age of tolerance acquisition.

Results

Sixty-one children with acute egg FPIES were enrolled, 34 (56%) males and 27 (44%) females. Tolerance to cooked egg has been demonstrated by 47/61 (77%) children at a mean age of 30.2 months. For 32 of them, tolerance to raw egg has been demonstrated at a mean age of 43.9 months. No episodes of severe adverse reaction after baked egg ingestion have been recorded.

Conclusions

It is possible to perform an OFC with baked egg, to verify the possible acquisition of tolerance, at about 30 months of life in children with acute egg FPIES.
Keywords:CI  confidence interval  FA  food allergy  FPIES  food protein-induced enterocolitis syndrome  OFC  oral food challenge  PbP  prick by prick  SD  standard deviation  SPT  skin prick test  USA  United States of America  Cooking  Egg  Food protein induced enterocolitis syndrome  Oral food challenge  Tolerance acquisition
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