A CASE OF FOOD-PROTEIN-INDUCED ENTEROCOLITIS SYNDROME WITH JAPANESE CLAM

Introduction Food-protein-induced enterocolitis syndrome (FPIES) with solid food is rare, and the appropriate diagnostic laboratory test has not been established. We evaluated the usefulness of lymphocyte proliferating response (LPR) with clam extract for scratch test in FPIES. Methods A 5-year-old girl with a history of severe vomiting and abdominal pain following clam ingestion was evaluated. Her clam-specific IgE was Results LPR using boiled clam showed false positive even in normal subjects because of Lipopolysaccharide in the clam. Therefore we used a Torii scratch solution of clam to stimulate lymphocytes. The highest stimulation index (SI = 3H-incorporation in stimulated cultures / 3H-incorporation in unstimulated cultures) was 27.1 in the patient and 3.2-3.9 in normal subjects. Proinflammatory cytokines and Th1 cytokines were induced in the culture supernatant of the patient's sample. Conclusions LPR with clam scratch solution is useful to diagnose FPIES with clam.