Pediatrics international : official journal of the Japan Pediatric Society 2017 04 22() doi 10.1111/ped.13305
Although the serum C-reactive protein (CRP) level and the percentage of eosinophils in peripheral blood (Eo) are increased at onset in infants with food protein-induced enterocolitis syndrome (FPIES), the relationship of these laboratory findings with the prognosis is presently unknown.
Correlations of the serum CRP levels and Eo at onset with the prognosis was analyzed in 32 patients with FPIES caused by cow’s milk (CM).
The rate of tolerance acquisition was 18.8, 56.3, 87.5, and 96.9% at the ages of 6, 12, 24, and 36 months, respectively. The serum CRP level increased in 50% of subjects at onset (median 0.21 mg/dL, range <0.20-18.2 mg/dL) and Eo elevated in 71.9% of subjects at onset (7.1%, 1.0-50.5%). The time of tolerance acquisition showed a significant positive correlation with the serum CRP level at onset (r=0.45, p<0.01), while it had a significant negative correlation with Eo at onset (r=-0.36, p<0.05). Although CM-specific IgE antibody (sIgE) was positive in 9 of 32 FPIES patients at onset (median 0.93, range 0.38-18.9 kU/L), it decreased thereafter. CM-sIgE at onset did not correlate significantly with the prognosis (r=0.22, p>0.05).
These results suggest that the serum CRP level is not only an indicator of the activity of intestinal inflammation, but also a useful parameter of poor prognosis in patients with FPIES. By contrast, eosinophilia at onset could be used as a maker of good prognosis, suggesting to have some beneficial effects in pathophysiology of FPIES. This article is protected by copyright. All rights reserved.