Syndrome d’entérocolite induit par les protéines alimentaires au poisson et aux fruits de mer dans une population pédiatrique belge

Study objective

The study aims to analyse 36 children presenting with acute fish and shellfish food protein-induced enterocolitis syndrome.

Patients and methods

This is a retrospective, single-centre study conducted between 2016 and 2024. Diagnosis was established based on the international diagnostic criteria published in 2017.

Results

The most frequently implicated foods were cod and prawns. The median age at first reaction was 12 months for fish and 61 months for shellfish. Only one out of 35 patients showed positive allergological tests, but 21 out of 36 patients had a personal history of atopy. Twenty-eight patients reacted exclusively to fish, 6 exclusively to shellfish, and 2 to both. Eight patients reacted to multiple types of fish, while 13 tolerated types of fish other than the one responsible for the initial reaction. Four children also reacted to other types of food.

Conclusion

This study confirms that fish is one of the most important triggers of food protein-induced enterocolitis in children in Europe and that reactions to shellfish are more frequent at a later age. These patients generally tolerate other types of fish and shellfish than those responsible for the initial reaction. Therefore, it is important to encourage patients to incorporate other varieties of these foods in their diet, if necessary with an introduction through an oral food challenge.