Comparison of FPIES in children and adults
| Variable | Children | Adults |
|---|---|---|
| Prevalence (USA) | 0.34–0.70% | 0.22% |
| Risk factors | Genetic: trisomy 21, father or sibling with FPIES; Environmental: birth via cesarean section, perinatal antibiotics, gut dysbiosis, and timing and pattern of solid food introduction in infancy [1, 14, 16] | Unknown |
| Sex | Equal or slight male predominance | Female 80% |
| Food triggers | Cow’s milk, oat, rice, egg, peanut, fish, avocado, and sweet potato | Seafood (shellfish and fish); rarely cow’s milk, egg, and wheat |
| Symptoms | Repetitive, projectile emesis, lethargy, and pallor | Severe abdominal pain, vomiting, and diarrhea |
| Time to onset of symptoms | 1–4 h | 1–6 h |
| Atypical FPIES (IgE-food sensitization) | About 5–20% | < 5% |
| Progression to immediate IgE mediated reactions in those with atypical FPIES | Reported by Onesimo et al. [27] | Not reported |
| Chronic FPIES | About 10% | Unknown, only 1 case published [16] |
| Natural history | Generally favorable, majority resolve by age 3–5, except fish FPIES, only 30–40% resolve by age 3–5Peanut FPIES, unknown natural history | Less favorable |
| Allergic comorbidities | High | High |
