Food protein-induced enterocolitis syndrome – a little-known form of non-IgE-mediated food hypersensitivity

Food protein-induced enterocolitis syndrome (FPIES) is a presentation of non-IgE-mediated food allergy and is probably more common than is currently diagnosed. Epidemiological data that estimate the prevalence of this disease are limited. In infancy it is usually induced by cow’s milk protein, rice, and soybean; in older children and adults fish and seashell may be the triggering factors. It is characterised by the presence of vomiting and diarrhoea that can lead to dehydration, lethargy, pallor, and metabolic acidosis. Chronic FPIES usually presents as failure to thrive. The diagnosis is based on clinical criteria. Potential cases can be misdiagnosed as more common paediatric illnesses, such as gastroenteritis or sepsis. Treatment consists of education and avoidance of the offending foods. In 2017 international guidelines for the diagnosis and management of FPIES were published [1]. This article contains current information on food protein-induced enterocolitis syndrome.

REFERENCES (14)

Nowak-Węgrzyn A, Chehade M, Groetch ME, et al. International consensus guidelines for the diagnosis and management of food protein–induced enterocolitis syndrome: Executive summary – Workgroup Report of the Adverse Reactions to Foods Committee, American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol 2017; 139: 1111-1126.e4.

Google Scholar

Boyce JA, Jones SM, Rock L, et al. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel. Vol 126. Elsevier Ltd. 2010.

Google Scholar

Sicherer SH, Sampson HA. Food Allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention and management. J Allergy Clin Immunol 2017; 141: 41-58.

Google Scholar

Bingemann TA, Sood P, Järvinen KM. Food Protein-Induced Enterocolitis Syndrome. Immunol Allergy Clin North Am 2018; 38: 141-152.

Google Scholar

Katz Y, Goldberg MR, Rajuan N, et al. The prevalence and natural course of food protein-induced enterocolitis syndrome to cow’s milk: A large-scale, prospective population-based study. J Allergy Clin Immunol 2011; 127: 647-653.

Google Scholar

Michelet M, Schluckebier D, Petit L-M, et al. Food protein-induced enterocolitis syndrome – a review of the literature with focus on clinical management. J Asthma Allergy 2017; 10: 197-207.

Google Scholar

Mehr S, Frith K, Barnes EH, et al. Food protein-induced enterocolitis syndrome in Australia: A population-based study, 2012-2014. J Allergy Clin Immunol 2017; 140: 1323-1330.

Google Scholar

Nowak-Wegrzyn A, Spergel JM. Food protein–induced enterocolitis syndrome: Not so rare after all! J Allergy Clin Immunol 2017; 140: 1275-1276.

Google Scholar

Vila Sexto L. Latest insights on Food Protein-Induced Enterocolitis Syndrome: an emerging medical condition. J Investig Allergol Clin Immunol 2018; 28: 13-23.

Google Scholar

10.

Biermé P, Nowak-Wegrzyn A, Caubet JC. Non-IgE-mediated gastrointestinal food allergies. Curr Opin Pediatr 2017; 29: 697-703.

Google Scholar

11.

Sánchez-Salguero CA. FPIES: The dark side of food allergy. Allergol Immunopathol (Madr) 2017; 45: 209-211.

Google Scholar

12.

Muraro A, Lemanske RF, Castells M, et al. Precision medicine in allergic disease—food allergy, drug allergy, and anaphylaxis—PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology. Allergy Eur J Allergy Clin Immunol 2017; 72: 1006-1021.

Google Scholar

13.

Fiocchi A, Brozek J, Schünemann H, et al. World allergy organization (WAO) diagnosis and rationale for action against cow’s milk allergy (DRACMA) guidelines. Pediatr Allergy Immunol 2010; 21 (Suppl. 21): 1-125.

Google Scholar

14.

Luyt D, Ball H, Makwana N, et al. BSACI guideline for the diagnosis and management of cow’s milk allergy. Clin Exp Allergy 2014; 44: 642-672.

Google Scholar

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