Food Protein-Induced Enterocolitis Syndrome in Children: A Case Report

Food protein-induced enterocolitis syndrome (FPIES) is a rare form of non-IgE-mediated food allergy that remains underrecognized and is often responsible for diagnostic delay. We report the case of an eight-year-old child with a history of celiac disease, presenting with recurrent episodes of abdominal pain and vomiting occurring in a delayed manner after ingestion of specific foods. The clinical presentation was characterized by delayed, intermittent, and reproducible gastrointestinal symptoms. Standard allergy investigations, including specific IgE testing and prick-to-prick testing with the suspected food allergens, were negative, supporting a non-IgE-mediated mechanism strongly suggestive of FPIES. Clinical evolution was marked by improvement following elimination of the implicated foods. This case highlights the diagnostic challenges of this condition and emphasizes the importance of a rigorous clinical approach in children presenting with unexplained gastrointestinal symptoms.