@article {7739, title = {Food protein-induced enterocolitis syndrome caused by fish and/or shellfish in Italy.}, journal = {Pediatr Allergy Immunol}, year = {2015}, month = {2015 Aug 19}, abstract = {

BACKGROUND: The study describes the demographic features, culprit foods, clinical features and outcomes for children presenting with acute fish and/or shellfish food protein-induced enterocolitis syndrome (FPIES) in four Italian paediatric allergy centres.

METHODS: A retrospective/prospective study was undertaken. All children diagnosed with fish or shellfish FPIES were enrolled. The diagnosis of FPIES was based on Sicherer{\textquoteright}s or Miceli Sopo clinical criteria. Skin prick tests (SPT) were performed in all patients, at the time of diagnosis and prior to OFC.

RESULTS: Seventy children were enrolled. Mean age at first episode was 14 months (range 6-46 months); mean age at diagnosis was 34 months (range 6-164 months). Sole and cod were the fish most commonly implicated. Fifty-seven of 70 (81\%) children had FPIES exclusively to fish, 37 of 57 (65\%) children had single-fish FPIES, 20 of 57 (35\%) multiple-fish FPIES, nine of 70 (13\%) presented adverse reactions exclusively to shellfish, and four of 70 (6\%) presented adverse reactions to both fish and shellfish. Only four (5.7\%) children presented episodes of acute FPIES with different foods (2 to cow{\textquoteright}s milk, 1 to egg, 1 to beef); in all cases, onset was prior to that of fish or shellfish FPIES. Fifteen of 70 (21\%) children tolerated fish other than the offending fish. Twenty-four of 70 (34\%) children achieved tolerance (age range 24-102 months).

CONCLUSIONS: The chief peculiarities of acute fish and shellfish FPIES, compared to more frequent cow{\textquoteright}s milk or soy FPIES, are (i) later age of onset, (ii) longer persistence and (iii) possibility of tolerating fish other than the offending fish. Adverse reactions with shellfish are possible.

}, issn = {1399-3038}, doi = {10.1111/pai.12461}, author = {Miceli Sopo, Stefano and Monaco, Serena and Badina, Laura and Barni, Simona and Longo, Giorgio and Novembre, Elio and Viola, Serena and Monti, Giovanna} }