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Food protein-induced enterocolitis syndrome as a cause for infant hypotension

Ryan W Coates1, Kevin R Weaver, Rezarta Lloyd

  • 1Lehigh Valley Hospital and Health Network, Department of Emergency Medicine, Allentown, Pennsylvania.

The Western Journal of Emergency Medicine
|January 7, 2012
PubMed

Insights

Food Protein-Induced Enterocolitis Syndrome (FPIES) can cause vomiting and hypotension in infants, often mistaken for sepsis. Early recognition involves considering FPIES with gastrointestinal symptoms and recent food introduction.

Area of Science:

  • Pediatric Gastroenterology
  • Allergy Immunology

Background:

  • Food Protein-Induced Enterocolitis Syndrome (FPIES) is a non-IgE mediated hypersensitivity.
  • FPIES commonly presents in infants with gastrointestinal distress, often mimicking other acute conditions.

Purpose of the Study:

  • To highlight the importance of considering FPIES in infants presenting with vomiting and hypotension.
  • To emphasize the role of dietary history in the early diagnosis of FPIES.

Main Methods:

  • Case report of a 5-month-old male infant with recurrent episodes of vomiting and hypotension.
  • Diagnostic process involving clinical presentation, dietary history, and exclusion of infectious causes.

Main Results:

  • The infant experienced two distinct episodes of severe vomiting and hypotension hours after consuming specific foods (squash, sweet potatoes).
  • Initial presentation was misdiagnosed as sepsis, delaying the FPIES diagnosis.
  • Subsequent episodes confirmed the FPIES diagnosis, with symptom resolution after supportive care and food avoidance.

Conclusions:

  • FPIES should be a key consideration for infants presenting to the emergency department with gastrointestinal symptoms and hypotension.
  • Thorough dietary history, including timing of new food introduction, is crucial for prompt FPIES recognition and management.

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