Clinical manifestations of food protein-induced enterocolitis syndrome
- 1 June 2014
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Allergy and Clinical Immunology
- Vol. 14 (3), 217-221
- https://doi.org/10.1097/aci.0000000000000052
Abstract
To raise awareness among healthcare providers about the clinical and laboratory findings in acute and chronic food protein-induced enterocolitis syndrome (FPIES). FPIES can be caused by trivial exposure or rare foods. FPIES is a non-IgE-mediated reaction that usually presents with acute severe repetitive vomiting and diarrhea associated with lethargy, pallor, dehydration, and even hypovolemic shock. Manifestations resolve usually within 24-48 h of elimination of the causative food. In chronic cases, symptoms may include persistent diarrhea, poor weight gain, failure to thrive, and improvement may take several days after the food elimination. In the acute cases, laboratory evaluation may reveal thrombocytosis and neutrophilia, peaking about 6 h postingestion. Depending on the severity, metabolic acidosis and methemoglobinemia may occur. In chronic cases, anemia, hypoalbuminemia and eosinophilia may be seen. Radiologic evaluation or other procedures, such as endoscopy and gastric juice analysis may show nonspecific abnormal findings. The diagnosis is based on clinical manifestations. Further studies looking at the phenotypes of FPIES are needed to identify clinical subtypes, and to understand the predisposing factors for developing FPIES compared with immediate-type, IgE-mediated gastroenteropathies.Keywords
This publication has 23 references indexed in Scilit:
- Egg yolk: An unusual trigger of food protein‐induced enterocolitis syndromePediatric Allergy and Immunology, 2013
- Manifestations, Diagnosis, and Management of Food Protein-Induced Enterocolitis SyndromePediatric Annals, 2013
- Food Protein-induced Enterocolitis Syndrome: Insights from Review of a Large Referral PopulationThe Journal of Allergy and Clinical Immunology: In Practice, 2013
- Food Protein-Induced Enterocolitis Syndrome (FPIES): Current Management Strategies and Review of the LiteratureThe Journal of Allergy and Clinical Immunology: In Practice, 2013
- Food protein-induced enterocolitis syndrome to trivial oral mucosal contactEuropean Journal of Pediatrics, 2013
- Do Not Laparotomize Food Protein-Induced Enterocolitis SyndromePediatric Emergency Care, 2007
- Case Report of Methemoglobinemia in Two Patients with Food Protein-Induced EnterocolitisClinical Pediatrics, 2006
- Food Protein-Induced Enterocolitis Syndrome: Clinical PerspectivesJournal of Pediatric Gastroenterology and Nutrition, 2000
- Clinical features of food protein–induced enterocolitis syndromeThe Journal of Pediatrics, 1998
- Milk- and soy-induced enterocolitis of infancy: Clinical features and standardization of challengeThe Journal of Pediatrics, 1978