OBJECTIVE: This study aimed to evaluate tolerance development and its assessment in a Swedish cohort.
METHODS: This was a prospective follow-up study of a Swedish cohort of 113 children, followed at 25 pediatric departments, with acute FPIES. Data on oral food challenges and FPIES resolution were collected through chart reviews and, if incomplete, supplemental caregiver interviews.
RESULTS: The median age at last follow-up was 5.6 years (range: 8.7 months to 16.5 years). Eighty-three children (73%) developed tolerance to 96 of 137 (70%) foods: 93% for cow\'s milk, 92% for oat, and 46% for fish. The median age when tolerance was developed was 36.0 months (interquartile range: 23.7-48.2 months): 24.4 months for cow\'s milk, 30.1 months for oat, and 49.4 months for fish. Tolerance was determined in hospital in 45% of cases. Five percent demonstrated allergic sensitization to their FPIES trigger food. Age at tolerance development did not differ between sensitized and nonsensitized patients.
CONCLUSIONS: Most of the children in this Swedish cohort with FPIES achieved tolerance before age 4 years. Cow\'s milk- and oat-induced FPIES had similar remission patterns, with early resolution. Development of tolerance to fish occurred significantly later compared with all other FPIES-inducing foods.
目的:本研究旨在评估瑞典队列中的耐受性发展及其评估。
方法:这是一项瑞典队列113名儿童的前瞻性随访研究,在25个儿科,急性FPIES。通过图表审查和收集有关口服食物挑战和FPIES分辨率的数据,如果不完整,补充护理人员访谈。
结果:最后一次随访的中位年龄为5.6岁(范围为8.7个月至16.5岁)。83名儿童(73%)对137种食物中的96种(70%)产生了耐受性;93%对牛奶,92%为燕麦,46%为鱼类。产生耐受性的中位年龄为36.0个月(IQR23.7至48.2个月):牛奶为24.4个月,燕麦30.1个月,鱼类49.4个月。在45%的病例中,在医院确定了耐受性。5%的人对其FPIES触发食物表现出过敏致敏。致敏和非致敏患者的耐受性发展年龄没有差异。
结论:该瑞典FPIES患者队列中的大多数儿童在4岁之前就达到了耐受性。奶牛的牛奶和燕麦诱导的FPIES具有相似的缓解模式,早日决议。与所有其他FPIES诱导食物相比,对鱼类的耐受性的发展明显较晚。