Pediatric Health, Medicine and Therapeutics (Oct 2023)
Diagnostic and Management Strategies of Food Protein-Induced Enterocolitis Syndrome: Current Perspectives
Abstract
Angela Mulé, Catherine Prattico, Adnan Al Ali, Pasquale Mulé, Moshe Ben-Shoshan Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children’s Hospital, McGill University Health Centre, Montreal, QC, CanadaCorrespondence: Moshe Ben-Shoshan, Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children’s Hospital, McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC, H4A 3J1, Canada, Tel +1 514 412-4400, Fax +1 514 412-4288, Email [email protected]: Food protein-induced enterocolitis syndrome (FPIES) is a form of non-IgE mediated food allergy that presents with delayed gastrointestinal symptoms after ingestion of the trigger food. The data regarding FPIES are sparse, despite being recognized as a distinct clinical entity. This narrative review presents the characteristics of this disorder in the pediatric population, as well-standard diagnostic and management protocols. FPIES can be classified into acute and chronic subtypes, and some cases may develop into an IgE-mediated allergy. Given that skin prick tests and specific IgE levels are negative in the majority of cases, diagnosis relies on clinical history and oral food challenges. Management involves elimination diets, assessment of tolerance through oral food challenges, and rehydration in the event of a reaction. Future research should focus on improving diagnostic methods, illustrating underlying pathogenesis and biomarkers, and assessing long-term natural history. Increased knowledge and awareness for FPIES are required.Keywords: FPIES, non-IgE mediated food allergy, oral food challenge, elimination diet
