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Food Protein-Induced Enterocolitis Syndrome

Abstract

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NORD is very grateful to Jonathan M. Spergel, MD, PhD, Chief, Allergy Section, Professor of Pediatrics, Stuart E. Starr Endowed Chair in Pediatrics, Division of Allergy and Immunology, The Children's Hospital of Philadelphia, Perelman School of Medicine at Univ. of Pennsylvania, for assistance in the preparation of this report.

Synonyms of Food Protein-Induced Enterocolitis Syndrome

  • dietary protein enterocolitis
  • FPIES

Disorder Subdivisions

  • No subdivisions found.

General Discussion

Summary
Food protein-induced enterocolitis syndrome (FPIES) is an uncommon disorder characterized by an allergic reaction to food that affects the gastrointestinal system. The term enterocolitis specially refers to inflammation of the small and large intestines. Individuals with FPIES experience profuse vomiting and diarrhea that usually develops approximately 2-6 hours after ingesting the offending food. Additional symptoms include pallor, lethargy, and abdominal swelling (distension). Symptoms can be severe and can potentially cause acute dehydration and/or hypovolemic shock. The most common triggers for an episode are milk, soy, and rice, but the disorder has been associated with a wide range of food proteins. Many children develop a tolerance to the offending foods by the age of three, however, in some cases, the disorder persists. Removal of the offending food should lead to a complete resolution of symptoms. The exact, underlying immune system mechanisms that are involved in the development of FPIES are unknown.

Introduction
Several different gastrointestinal disorders in children are believed to be caused by an abnormal immunologic reaction to dietary proteins. They are generally classified into three groups: IgE-mediated (as in classic food allergies), non-IgE-mediated, or mixed (a combination of both). IgE stands for immunoglobulin E, an antibody that the immune system creates in response to an allergic reaction and is often implicated in food allergies. Food specific IgE antibodies are typically not involved in FPIES. The disorder is presumed to be cell-mediated. Many researchers consider FPIES the severe end of a spectrum or continuum of disease involving non-IgE-mediated gastrointestinal food allergy disorders. This spectrum also includes proctocolitis and food-protein induced enteropathy.

Organizations related to Food Protein-Induced Enterocolitis Syndrome

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