Researchers from CHOP have discovered that children with FPIES have a significantly higher chance of being diagnosed with other allergies
The researchers from the Children’s Hospital of Philadelphia (CHOP) have found that children with a rare food allergy known as food protein-induced enterocolitis syndrome (FPIES), have a significantly higher chance of being diagnosed with other allergic conditions. These conditions include eczema, traditional food allergy and asthma. However, the researchers also found that FPIES did not directly cause those other allergies.
Understanding the relationship between FPIES and other allergies
The condition causes repetitive vomiting, diarrhoea, and lethargy several hours after eating a trigger food, frequently cow’s milk, soy, and grains. The condition typically develops during infancy, although it can sometimes occur in older children and adults.
Melanie Ruffner, M.D., Ph.D., attending physician in the Division of Allergy and Immunology and the Center for Pediatric Eosinophilic Disorders at CHOP said: “This work refines our view of the natural history of FPIES and expands our understanding of the relationship between this condition and other allergic diseases,
“It’s important for clinicians to keep in mind that patients with FPIES have a higher frequency of allergic manifestations and therefore provide appropriate screening and care as needed.”
Investigating a potential link
Previous research has collectively shown patients with FPIES have increased rates of eczema, other food allergies and asthma – so-called atopic allergies – researchers have not investigated the association between FPIES and other allergies to look for a potential causal link.
To begin the investigation Ruffner and her collaborators looked at a cohort of more than 150,000 paediatric patients, of which 214 had FPIES. The researchers followed the patients over a period of time to see if there were differences in the timing of when FPIES patients developed atopic allergies compared to other patients. The investigators then compared the rate of atopic allergies in FPIES patients to those without FPIES.
Higher allergy rates
The results published in the Journal of Allergy and Clinical Immunology: In Practice, reveals that those with FPIES had substantially higher allergy rates than patients without the condition.
FPIES patients were diagnosed with traditional food allergy at about six times the rate of those without FPIES and with atopic dermatitis at about twice the rate. The research team found that there was a slightly smaller increase in the rate of asthma diagnoses, but those with FPIES were still diagnosed at a higher rate than those without the disease.
Disproving a causal link between FPIES and allergies in later life
However, when the research team looked at the timing of the development of allergies, and whether a diagnosis of FPIES would lead to atopic allergies later in life, they did not find a causal link between the two.
Therefore, FPIES does not cause other allergic disorders but instead is associated with them unlike the progression of atopic disorders like eczema in infants to hay fever, food allergies and asthma in older children.
David Hill, M.D., Ph.D., corresponding author, attending physician in CHOP’s Division of Allergy and Immunology explained that: “Although there is an increased rate of atopic allergies in patients with FPIES, our analyses demonstrate that a prior diagnosis of FPIES does not increase the rate of atopic allergies later in life,
“This pattern of association supports a yet-unknown cause, such as a shared predisposition to both types of allergy.”
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