Food protein-induced enterocolitis syndrome, from practice to theory

Abstract

Food protein-induced enterocolitis syndrome (FPIES) is an allergic disease, probably non-IgE-mediated, with expression predominantly in the GI tract. The most characteristic symptom is repeated, debilitating vomiting. It occurs 2−6 h after ingestion of culprit food and is usually accompanied by pallor and lethargy. There may be diarrhea, and in 10−20% of cases, severe hypotension. These symptoms resolve completely within a few hours. The food most frequently involved is cow’s milk, followed by rice, but many other foods may be involved. The prognosis is generally good in a few years. In this review the authors try to cope, with the help of some case histories, with the practical clinical aspects of FPIES. The authors also try to provide a management approach based on current knowledge, and finally, to point out the aspects of FPIES that are still controversial.

Keywords::

• cow’s milk allergy
• food allergy
• food protein-induced enterocolitis syndrome
• oral food challenge
• vomiting

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Notes

CM: Cow’s milk; FPIES: Food protein-induced enterocolitis syndrome.