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Latest insights on Food Protein-Induced Enterocolitis Syndrome: an emerging medical condition

Vila Sexto L

Pediatric Allergy Department, Children’s Hospital Teresa Herrera, La Coruña

J Investig Allergol Clin Immunol 2018; Vol. 28(1)
doi: 10.18176/jiaci.0192

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated gastrointestinal food hypersensitivity, characterized by profuse vomiting, frequently associated to pallor or/and lethargy that appears within 1 to 3 hours after ingestion of the offending food. There is a less frequent chronic form of FPIES, presenting with protracted vomiting, diarrhea or both, accompanied by poor growth.
Although FPIES is considered a rare allergic disorder, in the last few years there have been an increasing number of reports about it indicating if not a real increase in incidence, at least an increased awareness of this condition by pediatricians.
Foods more frequently implicated are CM, soy formula, grains and fish, depending on the different areas of the world. Diagnosis is based on clinical manifestations and it requires a high index of suspicion, since we still lack a diagnostic laboratory tool. Early recognition of FPIES and removal of the offending food are mandatory. Recently international consensus guidelines have been published regarding diagnosis and management. Prognosis is usually good, with most children tolerating foods before 6 years of age.

Key words: FPIES, Food-Induced Enterocolitis, Food Allergy, Ondansetron, Oral Food Challenge, Cow’s Milk, Fish.