Food protein-induced enterocolitis syndrome (FPIES) among Canadian children living in Montreal.

Abstract

Background: Data on food protein induced enterocolitis syndrome (FPIES) are sparse. We aimed to evaluate sociodemographic characteristics, co-morbidities, and triggers of children presenting with FPIES. Tolerance to baked goods and resolution a year following diagnosis were also assessed.

Objective: Primary objective: To evaluate the sociodemographic characteristics, comorbidities, and triggers of children presenting with FPIES.

Secondary objective: To determine tolerance of baked goods for children with milk, egg, oat, and/or soy/grains induced FPIES and evaluate symptom resolution over three years.

Methods: Children with physician-diagnosed FPIES were enrolled and followed at the Montreal Children's Hospital and an affiliated clinic. Families were queried on the food trigger and co-morbidities, as well as clinical characteristics of reaction and management.

Results: Between November 2021 and April 2025, 87 children with a confirmed history of FPIES were enrolled. Patient ages ranged from 1 month to 13 years old, and 45% of patients were males. The most common triggers included egg, shellfish, milk, fish, peanut, oat, fruit, soy/grains, and rice. Symptoms included vomiting, lethargy, pallor, diarrhea, dehydration, and abdominal pain. Tolerance to baked forms was seen in the majority of patients. The triggers that had resolved FPIES include egg, milk, oat, soy/grains, peanut, shellfish.

Conclusion: The most common food triggers are egg, milk, and shellfish. The majority of reactions are not severe and baked goods containing the culprit food are often tolerated. Resolution of FPIES was reported in most patients one year following diagnosis.