(HealthDay News) — Fish is an important trigger of food protein-induced enterocolitis syndrome (FPIES), according to a study published online Oct. 20 in Allergy.

Sonsoles Infante, MD, from Hospital Infantil Universitario Gregorio Marañón in Spain, and colleagues assessed the evolution and follow-up of FPIES related to fish over a 20-year period. Data were included for 80 children diagnosed with FPIES by fish, with diagnosis based on Sicherer’s criteria.

The researchers found that the most frequently involved fish were hake, megrim, and sole (87.5%, 31.25%, and 23.75%). Of the patients, 56.25%, 28.75%, and 15%, respectively, reacted to 1 unique fish, 2 different fish, and 3 or more different fish. The number of reactions before diagnosis was 4 on average. The main symptoms at the debut were vomiting and vomiting with diarrhea (97.5% and 30%, respectively), which occurred in a mean time of 126.3 minutes after ingestion of the culprit fish. One hundred seventy-three oral food challenges were performed in 60 of the patients. Overall, 75.03% achieved tolerance to some kind of fish: 41.7% overcame their FPIES and 33.33% tolerated another type of fish. Twenty-five percent of patients challenged did not tolerate any fish during the oral food challenge.

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“In our population fish is, by far, the solid food most implicated in FPIES,” the authors write.


Infante S, Marco-Martín G, Sánchez-Domínguez M, et al. Food protein-induced enterocolitis syndrome by fish: Not necessarily a restricted diet. Allergy. 2017 Oct 20. doi: 10.1111/all.13336