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Review
. 2014 Jun;14(3):222-8.
doi: 10.1097/ACI.0000000000000055.

Definition, etiology, and diagnosis of food protein-induced enterocolitis syndrome

Elizabeth Feuille  1 , Anna Nowak-Węgrzyn
Affiliations
Free PMC article
Review

Definition, etiology, and diagnosis of food protein-induced enterocolitis syndrome

Elizabeth Feuille et al. Curr Opin Allergy Clin Immunol. 2014 Jun.
Free PMC article

Abstract

Purpose of review: Food protein-induced enterocolitis syndrome (FPIES) is a poorly understood non-IgE-mediated food hypersensitivity, primarily affecting infants and toddlers. There are few data regarding pathophysiology of FPIES that suggest local intestinal imbalance between TNF-α and TGF-β. Patients frequently present with multiple reactions, which are characterized by projectile, repetitive emesis, dehydration, lethargy, and failure to thrive. Despite the severity of presentation, the diagnosis is frequently delayed, and patients often undergo extensive and invasive evaluation prior to reaching the diagnosis.

Recent findings: Reviews published in the last year provide a general approach to diagnosis and management of FPIES and aim to increase awareness and understanding of FPIES among general pediatricians.

Summary: Multicenter studies are necessary to reevaluate and modify the oral food challenge criteria. Research on the pathophysiology of FPIES reactions is necessary to provide insight into the evidence-based approach to diagnosis and management of FPIES. Registries are needed to understand the phenotype, triggers, and prevalence of FPIES.

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