{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T19:08:33Z","timestamp":1786993713076,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,1,27]],"date-time":"2016-01-27T00:00:00Z","timestamp":1453852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Food protein\u2010induced enterocolitis (<jats:styled-content style=\"fixed-case\">FPIES<\/jats:styled-content>) is an uncommon, non\u2010IgE\u2010mediated food allergy that usually debuts in infancy with profuse vomiting, lethargy, and pallor 2\u20134 h following ingestion of the offending food. Its immune mechanism is not known. We aimed to describe the clinical features and outcome of children with fish\u2010<jats:styled-content style=\"fixed-case\">FPIES<\/jats:styled-content> as well as to investigate on cellular immune response implicated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective and follow\u2010up clinical study of children with <jats:styled-content style=\"fixed-case\">FPIES<\/jats:styled-content> by fish over a period between 2004 and 2013 was conducted. Measurement <jats:italic>in vitro<\/jats:italic> of both cytokine production in peripheral blood mononuclear cells (<jats:styled-content style=\"fixed-case\">PBMC<\/jats:styled-content>s) and expression of <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DR<\/jats:styled-content> in monocyte\u2010derived dendritic cells stimulated with fish extracts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen children (seven male and nine female) were included, with a mean age of onset at 10 months. Diagnosis was established after a median of 4 reactions. Twelve patients were treated in emergency room, and two were admitted in intensive care. Patch tests were positive in six patients. Skin prick tests (<jats:styled-content style=\"fixed-case\">SPT<\/jats:styled-content>s) and specific IgE to all fish tested were negative. Only three children reached tolerance at a mean age of 4.5 years. Eight children avoided fish because of positive oral food challenge (<jats:styled-content style=\"fixed-case\">OFC<\/jats:styled-content>) after 6 years of age. Other patients have not been challenged because of parent refusal to <jats:styled-content style=\"fixed-case\">OFC<\/jats:styled-content> or a recent diagnosis. <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1 was increased in patients, and a significant elevation of the <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DR<\/jats:styled-content> marker was also observed in these patients vs. control donors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">FPIES<\/jats:styled-content> caused by fish in many cases presents with severe clinical manifestations. Patch test has poor diagnostic value, and <jats:styled-content style=\"fixed-case\">OFC<\/jats:styled-content> is the gold standard to test tolerance. The cytokine <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1 may be implicated in the clinical symptoms. Higher expression of <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DR<\/jats:styled-content> in dendritic cells has also been detected in our patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pai.12529","type":"journal-article","created":{"date-parts":[[2015,12,18]],"date-time":"2015-12-18T05:12:15Z","timestamp":1450415535000},"page":"269-275","source":"Crossref","is-referenced-by-count":60,"title":["Clinical and immunological characteristics of a pediatric population with food protein\u2010induced enterocolitis syndrome (FPIES) to fish"],"prefix":"10.1111","volume":"27","author":[{"given":"Purificaci\u00f3n","family":"Gonz\u00e1lez\u2010Delgado","sequence":"first","affiliation":[{"name":"Servicio de Alergia Hospital General de Alicante Alicante Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Caparr\u00f3s","sequence":"additional","affiliation":[{"name":"Dpto. Medicina Cl\u00ednica Universidad Miguel Hern\u00e1ndez San Juan Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Victoria","family":"Moreno","sequence":"additional","affiliation":[{"name":"Dpto. Medicina Cl\u00ednica Universidad Miguel Hern\u00e1ndez San Juan Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Clemente","sequence":"additional","affiliation":[{"name":"Servicio de Pediatr\u00eda Hospital General de Alicante Alicante Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Flores","sequence":"additional","affiliation":[{"name":"Dpto. Medicina Cl\u00ednica Universidad Miguel Hern\u00e1ndez San Juan Spain"},{"name":"Servicio de An\u00e1lisis Cl\u00ednicos Hospital Universitario de San Juan San Juan Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Vel\u00e1squez","sequence":"additional","affiliation":[{"name":"Dpto. 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