title: Increased C-reactive protein and fever in Japanese infants with food protein-induced enterocolitis syndrome.
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.
authors.affiliation: Department of Allergy and Clinical Immunology, Shizuoka Children's Hospital, Shizuoka City, Shizuoka, Japan. mitsuaki-kimura@i.shizuoka-pho.jp.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Kimura
authors.affiliation: Department of Allergy and Clinical Immunology, Shizuoka Children's Hospital, Shizuoka City, Shizuoka, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Allergy and Clinical Immunology, Shizuoka Children's Hospital, Shizuoka City, Shizuoka, Japan.
authors.forename: Fumika
authors.initials: F
authors.lastname: Tokunaga
authors.affiliation: Department of Allergy and Clinical Immunology, Shizuoka Children's Hospital, Shizuoka City, Shizuoka, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Meguro
authors.affiliation: Department of Allergy and Clinical Immunology, Shizuoka Children's Hospital, Shizuoka City, Shizuoka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Shimomura
authors.affiliation: Department of Allergy and Clinical Immunology, Shizuoka Children's Hospital, Shizuoka City, Shizuoka, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Morishita
authors.affiliation: Department of Allergy and Clinical Immunology, Shizuoka Children's Hospital, Shizuoka City, Shizuoka, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Seto
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D004044:Dietary Proteins / Q000009:adverse effects* / Q000276:immunology; D004760:Enterocolitis / Q000097:blood* / Q000453:epidemiology / Q000276:immunology; D005260:Female; D005334:Fever / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D005512:Food Hypersensitivity / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013577:Syndrome
chemical_list: D015415:Biomarkers; D004044:Dietary Proteins; D002097:C-Reactive Protein
keywords: C-reactive protein; cow's milk; fever; food protein-induced enterocolitis syndrome; oral food challenge test