A clinical registry of FPIES patients shows 19% of patients triggered by eggs and 10% triggered by peanuts
MILWAUKEE, Feb. 10, 2025 /PRNewswire-PRWeb/ -- Eggs and peanuts have become emerging triggers in food protein-induced enterocolitis syndrome (FPIES) patients according to two new studies being presented at the 2025 AAAAI / WAO Joint Congress in San Diego, CA, later this month.
"Our multicenter FPIES registry, the Southwest FPIES consortium, led by Sara Anvari, MD, MSc, FAAAAI, from Baylor College of Medicine Texas Children's Hospital in collaboration with UT Southwestern, University of Arkansas for Medical Sciences and Dell Medical School UT Austin/Dell Children's Medical Center, provides insight into the prevalence and natural history of egg-induced FPIES in a diverse pediatric cohort. We found egg-induced FPIES affects approximately 1 in 5 pediatric FPIES patients, with a noticeable increase in cases over recent years. The study also highlights a high prevalence of comorbid atopic conditions and the unique challenge of overlapping IgE-mediated allergies, emphasizing the need for continued multidisciplinary care and research to better understand and manage this complex food allergy," says lead author Gail Tan, MD.
In this study, data specific to egg-induced FPIES was drawn from a multi-institutional FPIES registry established to include pediatric FPIES patients diagnosed since 2015. In the sample of 952 pediatric patients with FPIES, the largest multicenter registry to date, 19% were found to have egg-induced FPIES, with a median age of developing the allergy by 8 months old. Of these patients, 51.4% were female, 76.8% were White and 74% of were non-Hispanic. Researchers found that 25.4% of patients eventually achieved tolerance to egg with a median age of 31.5 months.
Egg was found to be the sole FPIES trigger in 63.5% of participants while 28.2% had 2-3 triggers and only 8.3% of participants had more than 3 triggers. The researchers noted that comorbid atopy was present in 77.3% of participants. Almost 9% of egg-induced FPIES patients were found to have a comorbid IgE-mediated egg allergy, while a significant increase in egg FPIES was observed across the four academic centers after 2017. Researchers noted that the rise in egg FPIES coincides with the implementation of early food allergen introduction and suggest further study to assess the association.
An additional study from the Southwest FPIES consortium examined peanut FPIES in the same clinical registry of 952 FPIES patients and found that peanuts are also an emerging trigger in FPIES.
"We have noticed an increase in peanut FPIES cases in recent years with approximately 1 in 10 pediatric FPIES patients having peanut as a trigger. Seven percent of these patients were found to have a concurrent IgE-mediated peanut allergy, further making the diagnoses of FPIES more challenging. Continued research in this field is needed to better understand the risk factors for FPIES and develop better diagnostic methods, with the hope of improving the quality of life of affected individuals and minimizing complications. Lastly, we aim to gain further insight in best practices in standardization of managing patients with FPIES diagnosis from oral food challenges to other necessary evaluations," said lead author Tevon Hood, DO, and co-author Hiral Waghela, MD.
In this cohort, peanut FPIES was observed in 10.5% of the total FPIES registry population with 51% of the patients being male, 80% White, 78% non-Hispanic and 90% commercially insured. A low variance in prevenance among male versus female patients was noted by researchers. The median age of the first peanut reaction was 7 months, and 25% of children achieved peanut tolerance during the study period at a median age of 29 months. Skin testing was performed in 73% of patients, of which 57% tested negative and 16% tested positive. Researchers found comorbid atopy in 50% of the patients, allergic rhinitis in 26%, asthma in 14% and IgE-mediated food allergy in 21% of children in the registry. A subset of patients had a mixed clinical presentation with both FPIES and IgE-mediated peanut reactions, further adding to diagnostic complexity.
These studies provide improved clinical understanding of both egg and peanut FPIES presentation, natural history and comorbidities, increasing awareness of emerging trends. A better understanding of FPIES may hasten the time to diagnosis and intervention, leading to better health outcomes for pediatric patients.
Visit aaaai.org to learn more about FPIES. Research presented at the 2025 AAAAI / WAO Joint Congress, February 28 – March 3 in San Diego, CA, is published in an online supplement to The Journal of Allergy and Clinical Immunology (JACI).
The American Academy of Allergy, Asthma & Immunology (AAAAI) is the leading membership organization of more than 7,100 allergists, asthma specialists, clinical immunologists and other professionals with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI is the go-to resource for patients living with allergies, asthma and immune deficiency disorders.
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Candace Archie, The American Academy of Allergy, Asthma & Immunology, (414) 272-6071, [email protected], aaaai.org
SOURCE The American Academy of Allergy, Asthma & Immunology
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