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Pediatr Int. 2016 Sep;58(9):826-30. doi: 10.1111/ped.12938. Epub 2016 May 16.

Increased C-reactive protein and fever in Japanese infants with food protein-induced enterocolitis syndrome.

Author information

1
Department of Allergy and Clinical Immunology, Shizuoka Children's Hospital, Shizuoka City, Shizuoka, Japan. mitsuaki-kimura@i.shizuoka-pho.jp.
2
Department of Allergy and Clinical Immunology, Shizuoka Children's Hospital, Shizuoka City, Shizuoka, Japan.

Abstract

BACKGROUND:

Increased C-reactive protein (CRP) and fever are observed in some infants with food protein-induced enterocolitis syndrome (FPIES) in Japan, but the reproducibility of these findings has not yet been confirmed on oral food challenge (OFC).

METHODS:

Fourteen infants with FPIES induced by cow's milk (CM) formula were enrolled. OFC using CM formula was performed on each infant once or repeatedly (total 18 tests), with a stepwise incremental protocol in an infection-controlled setting. CRP was measured 24 h after the last ingestion of the CM formula.

RESULTS:

Increased CRP was observed in 11 of the 18 OFC conducted (median, 2.60 mg/dL; range, 0.22-4.84 mg/dL). Fever was induced in six occasions during OFC. Serum CRP in the patients with fever increased to median 3.76 mg/dL (range, <0.7-4.84 mg/dL), which was significantly higher than that of the patients without fever (median <0.1 mg/dL; range, <0.1-2.6 mg/dL; P < 0.001). CRP during OFC significantly correlated with that at disease onset (rs = 0.62, P < 0.02). Three of the four patients with fever at disease onset also had fever during OFC.

CONCLUSIONS:

Increased CRP and fever are reproducible during OFC in some infants with FPIES, suggesting that these are not accidental phenomena, but instead are associated with FPIES itself in Japanese patients.

KEYWORDS:

C-reactive protein; cow's milk; fever; food protein-induced enterocolitis syndrome; oral food challenge test

PMID:
26824628
DOI:
10.1111/ped.12938
[Indexed for MEDLINE]

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