Open AccessFood protein-induced enterocolitis syndrome in pediatric practice
Author(s) -
В. П. Новикова,
Новикова Валерия Павловна,
Alevtina A. Pokhlebkina,
Похлебкина Алевтина Алексеевна
Publication year - 2019
Publication title -
pediatr
Language(s) - English
Resource type - Journals
eISSN - 2587-6252
pISSN - 2079-7850
DOI - 10.17816/ped10269-74
Subject(s) - medicine , lethargy , enterocolitis , thrombocytosis , hypoalbuminemia , oral food challenge , necrotizing enterocolitis , oliguria , pallor , hypoproteinemia , gastroenterology , food allergy , pediatrics , immunology , allergy , platelet , renal function
One of non-IgE-mediated disorders that pediatricians and allergologists have to deal with is food protein-induced enterocolitis syndrome (Food Protein Induced Enterocolitis Syndrome, FPIES). Cow milk and soy proteins are the most common cause of FPIES. Other foods that can cause FPIES include a wide range of solid food stuffs, such as grains, vegetables, fruits, and poultry. Food-borne enterocolitis is usually accompanied by acute recurring vomiting and diarrhea, lethargy, pallor, dehydration, and even hypovolemic shock. FPIES often occurs after the first introduction of complementary foods containing trigger products, usually not accompanied by fever or a significant increase in the level of C-reactive protein, and generally has a good prognosis. Depending on the severity of the disease, metabolic acidosis and meth-hemoglobinemia may develop. In chronic cases anemia, hypoalbuminemia and eosinophilia may occur. In acute cases laboratory evaluation may reveal thrombocytosis and neutrophilia, peaking 6 hours after a meal. Manifestations of FPIES usually disappear within 24-48 hours after elimination of the causative food. Radiological evaluation and other methods like endoscopy and gastric juice analysis can yield nonspecific results. Data on the incidence of FPIES is limited, and approximate assessment of affected children rate varies from 1.5 to 30 per 10,000. Further studies are needed to identify clinical subtypes and predisposing factors for the development of FPIES compared to immediate-type IgE-mediated gastroenteropathy.