Retrospective study identified fish and milk as the main culprits in cases of food protein-induced enterocolitis syndrome.

AIM: Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E (IgE)-mediated food allergy, which is confined to the gastrointestinal tract and occurs most frequently in the first year of life. Our aim was to examine the clinical features, causative agents and outcomes of Greek children with FPIES. METHODS: This was a five-year (2013-2017) retrospective study, based on chart reviews of 78 children with FPIES from six Greek paediatric allergy centres. RESULTS: Only five children needed an oral food challenge (OFC) for diagnosis, but 54 children (69%) had OFCs to monitor tolerance development. The most common problems were fish and milk, which affected affecting 42 (54%) and 25 (35%) of children, respectively. The median age of tolerance based on the results of the negative OFCs occurred by 34.0 (26.6-58.4) months. Fish and milk were tolerated by 24 (57%) and 13 (52%) of children by 43.8 and 24.3 months, respectively. Coexisting IgE sensitisation to the offending food was related to delayed tolerance. CONCLUSION: Fish and milk were the most common food allergies in our series of Greek children with FPIES. Cases with IgE sensitisation to the food trigger took longer to resolve their allergies.

The clinical significance of non-malignant neutropenia in hospitalized children.

Neutropenia in non-cancer patients is often discovered in the course of an evaluation for acute infection, and it is usually secondary to the infection itself rather than a predisposing factor of the infection. Although it is not a common finding in hospitalized pediatric patients, it causes a great concern to the treating physicians. The aim of this study was to determine the incidence, the etiology, and the clinical significance of neutropenia in previously healthy children admitted in a general pediatric ward. One thousand five hundred and forty-eight patients admitted during a period of 18 months were included in the study. The clinical characteristics, the complete blood count, and the sedimentation rate were recorded. A total of 143 (9.2%) pediatric patients were identified as neutropenic, with mean absolute neutrophilic count of 0.960 x 10(9)/l (SD 0.341 x 10(9)/l) and ranged from 0.200 to 1.499 x 10(9)/l. The neutropenic patients had lower hemoglobin of 11.2 mg/dl and ranged from 6.2 to 17.2 mg/dl compared to hemoglobin of 11.5 mg/dl, which ranged from 5.2 to 18.0 mg/dl of the individuals with normal neutrophils, p < 0.0001 and lower mean platelet count of 294 x 10(9)/l, which ranged from 122 to 929 x 10(9)/l compared to platelet count of 381 x 10(9)/l, which ranged from 90-165 x 10(9)/l of the individuals without neutropenia, p < 0.001. Additionally, those patients were significantly younger than the non-neutropenic ones. Infection was the most common cause of neutropenia, although none of them developed septicemia. The neutrophil count normalized in most of the patients before discharge. However, 12 (8.3%) of neutropenic patients were discharged with persistent findings. Two of those were finally diagnosed with autoimmune neutropenia. In conclusion, the acquired neutropenia in hospitalized patients without malignancy is mild to moderate. It has no influence on the clinical outcome. Importantly, it has short duration, and it is usually resolved before patient's discharge.