Food protein-induced enterocolitis syndrome

Area of Science:

• Allergy and Immunology
• Gastroenterology
• Pediatrics

Background:

• Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy impacting infants and adults.
• Prevalence estimates suggest FPIES affects up to 0.7% of infants, with increasing reports in adults, particularly shellfish-triggered cases.
• Diagnosis and management have been updated by international guidelines, but improved biomarkers and understanding of pathophysiology are needed.

Purpose of the Study:

• To review recent advancements in the diagnosis and management of FPIES.
• To explore the evolving understanding of FPIES pathophysiology, including the role of innate immune cells.
• To discuss current treatment strategies, including ondansetron and nutritional management.

Main Methods:

• Literature review of recent studies on FPIES.
• Analysis of updated diagnostic and management guidelines.
• Discussion of emerging research on FPIES pathophysiology and treatment.

Main Results:

• FPIES prevalence is higher than previously thought, affecting infants and adults.
• Adult FPIES, often shellfish-induced, presents diagnostic delays and prolonged courses.
• Ondansetron shows promise as an adjunct or first-line treatment for acute FPIES reactions.

Conclusions:

• Continued research is essential for developing new biomarkers and understanding FPIES pathophysiology.
• Current guidelines provide a framework for diagnosis and management, with evolving treatment options.
• A comprehensive approach integrating pathophysiology, diagnosis, and treatment is crucial for FPIES patient care.