Food protein-induced enterocolitis syndrome

Area of Science:

• Allergy and Immunology
• Gastroenterology
• Pediatric Medicine

Background:

• Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food allergy.
• Its pathophysiology involves intestinal inflammation, increased permeability, and fluid shifts post-antigen exposure.
• FPIES presents in acute and chronic forms, typically in infancy, but can persist into adulthood.

Purpose of the Study:

• To elucidate the pathophysiology of FPIES.
• To review diagnostic criteria and management strategies for FPIES.
• To highlight the need for further research into FPIES prevalence and biomarkers.

Main Methods:

• Clinical history review.
• Oral food challenge as the criterion standard for diagnosis.
• Review of current management strategies including food avoidance and rehydration.

Main Results:

• Acute FPIES: repetitive vomiting (1-4 hours post-ingestion), potentially leading to dehydration and shock. Diarrhea may occur within 24 hours.
• Chronic FPIES: intermittent vomiting/diarrhea, failure to thrive.
• FPIES typically resolves by school age but can persist or present in adulthood.

Conclusions:

• FPIES diagnosis is primarily clinical, confirmed by oral food challenge.
• Management requires strict trigger avoidance and prompt fluid rehydration.
• Further research is needed to understand FPIES pathophysiology, prevalence, and identify reliable biomarkers.