Non-IgE-mediated food allergy during infancy

Area of Science:

• Pediatric Allergy and Immunology
• Gastroenterology
• Clinical Nutrition

Background:

• Non-IgE-mediated food allergies are common in infants.
• Diagnosis and management are often challenging in primary care and subspecialty practices.

Purpose of the Study:

• To review recent advances in the diagnosis and management of non-IgE-mediated food allergies in infants.
• To focus on food protein-induced enterocolitis syndrome (FPIES) and related conditions.

Main Methods:

• Review of the 2017 International Consensus Guidelines for FPIES.
• Inclusion of 2019 European Academy of Allergy and Clinical Immunology position paper.
• Analysis of recent reports on FPIES diagnosis, triggers, and tolerance evaluation.

Main Results:

• FPIES is primarily diagnosed in infants, with delayed diagnoses being a significant issue.
• New and common food protein triggers have been identified.
• Novel approaches for evaluating tolerance are emerging.

Conclusions:

• Improved recognition and evaluation of non-IgE-mediated food allergies are expected with defined diagnostic criteria and prevalence data.
• Large-scale prospective studies are needed to understand incidence, prevalence, risk factors, and natural history.
• While food avoidance is key, further research into pathophysiology and biomarkers may yield new therapeutics.