Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study

Argiz L; Valsami-Fokianos M; Arasi S; Barni S; Boscia S; Bracaglia G; Bracamonte T; Carballeira I; Dinardo G; Echeverria L; Garcia E; Garcia-Magan C; Gomez-Rial J; Gonzalez-Delgado P; Fiocchi A; Garriga T; Ibrahim T; Infante S; Machinena A; Mangone G; Mori F; Moure JD; O'Valle V; Pascal M; Pecora V; Prieto A; Quevedo S; Salas A; Vazquez-Cortes S; Vila L; Martinon-Torres F; Gomez-Carballa A; Boyle RJ; Vazquez-Ortiz M

Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study

Background: Oral food challenge (OFC) is the criterion standard for diagnosis of acute food protein-induced enterocolitis syndrome (FPIES). No diagnostic/prognostic biomarkers are available, and OFC assessment criteria are not validated. Objective: To assess clinical-hematological changes and predic...

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Autores:	Argiz L, Valsami-Fokianos M, Arasi S, Barni S, Boscia S, Bracaglia G, Bracamonte T, Carballeira I, Dinardo G, Echeverria L, Garcia E, Garcia-Magan C, Gomez-Rial J, Gonzalez-Delgado P, Fiocchi A, Garriga T, Ibrahim T, Infante S, Machinena A, Mangone G, Mori F, Moure JD, O'Valle V, Pascal M, Pecora V, Prieto A, Quevedo S, Salas A, Vazquez-Cortes S, Vila L, Martinon-Torres F, Gomez-Carballa A, Boyle RJ, Vazquez-Ortiz M
Tipo de recurso:	artículo
Estado:	Versión publicada
Fecha de publicación:	2024
País:	España
Institución:	Fundació Sant Joan de Déu
Repositorio:	r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:	oai:fsjd.fundanetsuite.com:p26743
Acceso en línea:	https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=26743
Access Level:	acceso abierto
Palabra clave:	Food protein- induced enterocolitis syndrome (FPIES) Food allergy Oral food challenge Severity Allergic reactions Diagnosis Prognosis Pediatrics Children

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spelling	Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational StudyArgiz LValsami-Fokianos MArasi SBarni SBoscia SBracaglia GBracamonte TCarballeira IDinardo GEcheverria LGarcia EGarcia-Magan CGomez-Rial JGonzalez-Delgado PFiocchi AGarriga TIbrahim TInfante SMachinena AMangone GMori FMoure JDO'Valle VPascal MPecora VPrieto AQuevedo SSalas AVazquez-Cortes SVila LMartinon-Torres FGomez-Carballa ABoyle RJVazquez-Ortiz MFood protein- induced enterocolitis syndrome (FPIES)Food allergyOral food challengeSeverityAllergic reactionsDiagnosisPrognosisPediatricsChildrenBackground: Oral food challenge (OFC) is the criterion standard for diagnosis of acute food protein-induced enterocolitis syndrome (FPIES). No diagnostic/prognostic biomarkers are available, and OFC assessment criteria are not validated. Objective: To assess clinical-hematological changes and predictors of severity of FPIES reactions at OFC. Methods: This was an observational multicenter prospective study. Children aged 0 to 18 years diagnosed with acute FPIES were recruited at follow-up OFC in 12 tertiary centers in Spain and Italy. OFC outcomes (as positive/negative/inconclusive and mild/moderate/severe) were assessed on the basis of published "2017 FPIES Consensus" criteria. Clinical characteristics were recorded, and full blood cell count was done at baseline, reaction onset, and 4 hours later. Regression analysis was performed to assess predictors of severe reactions at OFC. Results: A total of 81 children had positive OFC (mild in 11% [9 of 81], moderate in 61% [49 of 81], and severe in 28% [23 of 81]). Increase in neutrophils and reduction in eosinophils, basophils, and lymphocytes were observed (P < .05). OFC was inconclusive in 19 cases despite objective signs or neutrophilia. Regression analysis showed that a 2-day OFC protocol where only 25% of an age-appropriate portion is given on day 1 (not sex, age, culprit food, cumulative dose, and previous reaction severity) was associated with reduced odds of severe reaction compared with giving multiple doses in a single day. Conclusions: Distinct hematological changes may help support FPIES diagnosis. Current OFC assessment criteria may not capture the broad spectrum of acute FPIES presentations. This 2-day protocol may be associated with a reduced risk of severe reactions. Future work should aim to develop safer OFC and non-OFC diagnostics for FPIES. (c) 2024 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/). (J Allergy Clin Immunol Pract 2024;12:2454-67)ELSEVIER2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=26743Journal of Allergy and Clinical Immunology-In PracticeISSN: 22132198ISSNe: 22132201reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p267432026-05-27T12:37:41Z
dc.title.none.fl_str_mv	Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study
title	Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study
spellingShingle	Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study Argiz L Food protein- induced enterocolitis syndrome (FPIES) Food allergy Oral food challenge Severity Allergic reactions Diagnosis Prognosis Pediatrics Children
title_short	Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study
title_full	Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study
title_fullStr	Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study
title_full_unstemmed	Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study
title_sort	Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study
dc.creator.none.fl_str_mv	Argiz L Valsami-Fokianos M Arasi S Barni S Boscia S Bracaglia G Bracamonte T Carballeira I Dinardo G Echeverria L Garcia E Garcia-Magan C Gomez-Rial J Gonzalez-Delgado P Fiocchi A Garriga T Ibrahim T Infante S Machinena A Mangone G Mori F Moure JD O'Valle V Pascal M Pecora V Prieto A Quevedo S Salas A Vazquez-Cortes S Vila L Martinon-Torres F Gomez-Carballa A Boyle RJ Vazquez-Ortiz M
author	Argiz L
author_facet	Argiz L Valsami-Fokianos M Arasi S Barni S Boscia S Bracaglia G Bracamonte T Carballeira I Dinardo G Echeverria L Garcia E Garcia-Magan C Gomez-Rial J Gonzalez-Delgado P Fiocchi A Garriga T Ibrahim T Infante S Machinena A Mangone G Mori F Moure JD O'Valle V Pascal M Pecora V Prieto A Quevedo S Salas A Vazquez-Cortes S Vila L Martinon-Torres F Gomez-Carballa A Boyle RJ Vazquez-Ortiz M
author_role	author
author2	Valsami-Fokianos M Arasi S Barni S Boscia S Bracaglia G Bracamonte T Carballeira I Dinardo G Echeverria L Garcia E Garcia-Magan C Gomez-Rial J Gonzalez-Delgado P Fiocchi A Garriga T Ibrahim T Infante S Machinena A Mangone G Mori F Moure JD O'Valle V Pascal M Pecora V Prieto A Quevedo S Salas A Vazquez-Cortes S Vila L Martinon-Torres F Gomez-Carballa A Boyle RJ Vazquez-Ortiz M
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author
dc.subject.none.fl_str_mv	Food protein- induced enterocolitis syndrome (FPIES) Food allergy Oral food challenge Severity Allergic reactions Diagnosis Prognosis Pediatrics Children
topic	Food protein- induced enterocolitis syndrome (FPIES) Food allergy Oral food challenge Severity Allergic reactions Diagnosis Prognosis Pediatrics Children
description	Background: Oral food challenge (OFC) is the criterion standard for diagnosis of acute food protein-induced enterocolitis syndrome (FPIES). No diagnostic/prognostic biomarkers are available, and OFC assessment criteria are not validated. Objective: To assess clinical-hematological changes and predictors of severity of FPIES reactions at OFC. Methods: This was an observational multicenter prospective study. Children aged 0 to 18 years diagnosed with acute FPIES were recruited at follow-up OFC in 12 tertiary centers in Spain and Italy. OFC outcomes (as positive/negative/inconclusive and mild/moderate/severe) were assessed on the basis of published "2017 FPIES Consensus" criteria. Clinical characteristics were recorded, and full blood cell count was done at baseline, reaction onset, and 4 hours later. Regression analysis was performed to assess predictors of severe reactions at OFC. Results: A total of 81 children had positive OFC (mild in 11% [9 of 81], moderate in 61% [49 of 81], and severe in 28% [23 of 81]). Increase in neutrophils and reduction in eosinophils, basophils, and lymphocytes were observed (P < .05). OFC was inconclusive in 19 cases despite objective signs or neutrophilia. Regression analysis showed that a 2-day OFC protocol where only 25% of an age-appropriate portion is given on day 1 (not sex, age, culprit food, cumulative dose, and previous reaction severity) was associated with reduced odds of severe reaction compared with giving multiple doses in a single day. Conclusions: Distinct hematological changes may help support FPIES diagnosis. Current OFC assessment criteria may not capture the broad spectrum of acute FPIES presentations. This 2-day protocol may be associated with a reduced risk of severe reactions. Future work should aim to develop safer OFC and non-OFC diagnostics for FPIES. (c) 2024 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/). (J Allergy Clin Immunol Pract 2024;12:2454-67)
publishDate	2024
dc.date.none.fl_str_mv	2024
dc.type.none.fl_str_mv	info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion
format	article
status_str	publishedVersion
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url	https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=26743
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.rights.none.fl_str_mv	info:eu-repo/semantics/openAccess
eu_rights_str_mv	openAccess
dc.publisher.none.fl_str_mv	ELSEVIER
publisher.none.fl_str_mv	ELSEVIER
dc.source.none.fl_str_mv	Journal of Allergy and Clinical Immunology-In Practice ISSN: 22132198 ISSNe: 22132201 reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu instname:Fundació Sant Joan de Déu
instname_str	Fundació Sant Joan de Déu
reponame_str	r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection	r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
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Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study

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