To explore the diagnostic value of combined detection of serum interleukin-27 (IL-27), transforming growth factor-β (TGF-β) and fecal calprotectin (FC) in children with food protein-induced enterocolitis syndrome (FPIES).

A total of 123 children with FPIES admitted to Suzhou Wujiang District Children's Hospital from March 2020 to August 2023 were retrospectively analyzed as the FPIES group. In addition, 154 children with common diarrhea who were admitted to the hospital during the same period were selected as the common diarrhea group, and 84 children who underwent health check-ups were selected as the healthy group. The baseline data and serum levels of IL-27, TGF-β and FC were compared among the three groups. The relationship between platelet count (PLT), eosinophil count (EOS), duration of vomiting and serum IL-27, TGF-β, FC in children with FPIES was analyzed. The relationship between serum IL-27, TGF-β and FC in FPIES children was analyzed. The diagnostic value of serum IL-27, TGF-β, FC and combined detection of the three indexes in FPIES was analyzed.

There were no statistically significant differences in gender, age and body mass index among the three groups (all P>0.05). However, the levels of PLT and EOS in the FPIES group were significantly higher than those in the common diarrhea group and the healthy group (all P<0.001), and the levels of PLT and EOS in the common diarrhea group were significantly higher than those in the healthy group (both P<0.001). The serum levels of IL-27, TGF-β and FC in the three groups showed a trend of FPIES group>general diarrhea group > healthy group (all P<0.001). In children with FPIES, PLT, EOS and vomiting duration were positively correlated with serum IL-27 (r=0.594, 0.617, 0.563), TGF-β (r=0.537, 0.633, 0.492) and FC (r=0.673, 0.773, 0.697) (all P<0.001). Serum IL-27 (r=0.444) and TGF-β (r=0.486) were positively correlated with FC in FPIES children (all P<0.001). There was a positive correlation between serum IL-27 and TGF-β (r=0.426, P<0.001). The diagnostic value of serum IL-27, TGF-β combined with FC (AUC=0.913) for FPIES was significantly higher than that of the individual detections of serum IL-27 (AUC=0.859), TGF-β (AUC=0.882), FC (AUC=0.901) (P<0.001, 0.006, 0.021).

Serum IL-27, TGF-β and FC are abnormally increased in children with FPIES. The combined detection of serum IL-27, TGF-β and FC has a high clinical diagnostic value for FPIES.