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Updated: May 12, 2026

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Published on: December 26, 2013
Delayed presentation of food protein-induced enterocolitis syndrome (FPIES) to okra in a toddler
Hunter Hall1, Sara Anvari2, Fallon Schultz3
1Department of Biology, Liberty University, Lynchburg, VA, USA.
Background:
Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E (IgE) -mediated food allergy predominantly observed in infants and characterized by the delayed onset of vomiting following ingestion of a trigger food. An increase in research and clinical consideration of FPIES has led to the discovery of unique deviations from the standard FPIES triggers and presentations.
Case Presentation:
A 34-month-old female patient with a history of consuming okra daily presented to medical attention after developing classic FPIES symptoms to okra beginning at 14-months of age.
Conclusions:
Recently, awareness about the varied nature of FPIES clinical presentation has come to light. This case is the first to describe FPIES to the fruit okra that developed over a 12-month time span after previously tolerating the food. This case serves to emphasize the importance of understanding the range of FPIES symptoms to improve recognition and expedite best practice recommendations.
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