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Related Experiment Videos

Rice protein-induced enterocolitis syndrome.

Iva Hojsak1, Mirjana Kljaić-Turkalj, Zrinjka Misak

  • 1Referral Center for Pediatric Gastroenterology and Nutrition, Zagreb Children's Hospital, Klaićeva 16, HR-10000 Zagreb, Croatia. ivahojsak@gmail.com

Clinical Nutrition (Edinburgh, Scotland)
|May 16, 2006
PubMed
Summary

Rice can cause food protein-induced enterocolitis syndrome (FPIES) in infants, a condition typically linked to cow's milk or soy. This study highlights rice as a potential trigger, emphasizing the need for its consideration in diagnosing infant FPIES.

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Area of Science:

  • Pediatric Allergy and Immunology
  • Gastroenterology
  • Clinical Nutrition

Background:

  • Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated allergic reaction, commonly associated with cow's milk and soy proteins.
  • FPIES diagnosis is challenging due to non-specific symptoms, often leading to delayed identification and extensive workups.
  • While common triggers are known, less common allergens like rice are infrequently reported, particularly in European cohorts.

Observation:

  • This case series retrospectively analyzed five infants presenting with severe vomiting, diarrhea, and dehydration.
  • Initial diagnostic evaluations did not consider allergy due to the severity and presentation of symptoms.
  • An open food challenge with rice was ultimately performed, leading to the diagnosis of rice-induced FPIES.

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Findings:

  • Infants experienced significant gastrointestinal distress and dehydration, necessitating a median of two hospitalizations for diagnosis.
  • Symptoms mimicked a broad spectrum of diseases, complicating the diagnostic process.
  • Open food challenge is the definitive diagnostic method for suspected rice protein-induced enterocolitis syndrome; other tests are insufficient.

Implications:

  • Hypoallergenic foods like rice can indeed trigger FPIES, challenging the assumption of their universal safety.
  • Rice-induced FPIES should be included in the differential diagnosis for infants presenting with profuse vomiting and prostration.
  • Early consideration of rice as an allergen can expedite diagnosis and appropriate management, preventing prolonged illness and hospitalization.