Food protein-induced enterocolitis syndrome to nuts: an increasing phenomenon.

Abstract

Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E (IgE)-mediated food allergy which typically presents in infancy. Although rice is a rare cause of IgE-mediated food allergy, it is one of the most common triggers of FPIES in Australia and the United States.1,2 Conversely, peanut and tree nuts are rarely described to cause FPIES, but are common triggers of IgE-mediated food reactions. Ruffner et al reported peanut and tree nut FPIES in only 2% and less than 1% of children, respectively, in a retrospective cohort of 462 children from a single institution. Mehr et al reported a single case (0.5%) of peanut FPIES in a prospective population-based study of 230 children. Case reports of peanut FPIES have been published, and 1 case of peanut FPIES was noted as a reason for discontinuation in the Learning Early About Peanut (LEAP) allergy trial. We recently noted an increase in the number of children being referred with peanut FPIES to our private allergy services, in Melbourne, Australia