Oral Food Challenge for FPIES in Practice—A Survey: Report from the Work Group on FPIES Within the Adverse Reactions to Foods Committee, FAED IS, AAAAI

Rory Nicolaides, J. Andrew Bird, Antonella Cianferoni, Terri Brown-Whitehorn, Anna Nowak-Wegrzyn

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Food protein–induced enterocolitis syndrome (FPIES) is a non–IgE-mediated food allergy diagnosed via history and/or an oral food challenge (OFC). Objective: To determine allergists’ approach to FPIES OFCs. Methods: A web-based survey was e-mailed to 1100 randomly selected American Academy of Allergy, Asthma and Immunology members. Results: A total of 132 individuals responded (12% response rate). A total of 95.5% (n = 105) of respondents perform OFCs in their practice, but only 58.7% (n = 71) perform FPIES OFCs. The median number of FPIES OFCs in children was reported as 3 per year (range, 0-76); all but 1 respondent (2.5%) had not performed any FPIES OFCs in adults. The most common FPIES OFC foods were cow's milk, rice, lightly cooked egg, oat, soy, baked milk, and baked egg. The decision to offer FPIES OFCs was based on the severity of past reactions, the patient and family's desire, and the patient's age. FPIES OFCs were most commonly performed in an outpatient setting, with placement of peripheral intravenous access depending on the severity of past reactions and with a serving appropriate for age divided into 3 equal portions administered over 30 minutes. There was significant variability in the approach to conducting FPIES OFCs. Most respondents (87.4%, n = 127) indicated that specific guidelines for performing FPIES OFCs would be helpful. Conclusions: Our study highlights the discordance in allergists’ practices performing OFCs for IgE-mediated food allergy compared with FPIES. The lack of universal agreement on the optimal way to perform OFCs in FPIES demonstrates the need for future studies to develop a standardized protocol for FPIES OFCs.

Original languageEnglish (US)
Pages (from-to)3608-3614.e1
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume9
Issue number10
DOIs
StatePublished - Oct 2021

Keywords

  • Diagnosis
  • FPIES
  • Food allergy
  • Food protein–induced enterocolitis syndrome
  • OFC
  • Oral food challenge

ASJC Scopus subject areas

  • Immunology and Allergy

Fingerprint

Dive into the research topics of 'Oral Food Challenge for FPIES in Practice—A Survey: Report from the Work Group on FPIES Within the Adverse Reactions to Foods Committee, FAED IS, AAAAI'. Together they form a unique fingerprint.

Cite this