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Current Allergy and Asthma Reports
Published in: Current Allergy and Asthma Reports 10/2022

06-05-2022 | Food Allergy | Pediatric Allergy and Immunology (W Dolen, Section Editor)

Update on Food Protein–Induced Enterocolitis Syndrome (FPIES)

Authors: Mary Grace Baker, M. Cecilia Berin, Scott Sicherer

Published in: Current Allergy and Asthma Reports | Issue 10/2022

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Abstract

Purpose of Review

Food protein–induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by delayed, and potentially severe, gastrointestinal symptoms. Since the advent of a specific diagnostic code and establishment of diagnostic guidelines, our understanding of this condition has grown.

Recent Findings

FPIES affects patients from early infancy into adulthood. Any food can be a trigger, and common culprit foods vary geographically and by age. An understanding of the complex underlying immune mechanisms remains elusive, although studies show pan-leukocyte activation, cytokine release, and increased gastrointestinal permeability. Management involves trigger avoidance, and patients may benefit from the support of a dietitian to ensure adequate nutrient intake. Tolerance develops over time for most children, but due to the risk of severe symptoms, re-introduction of a suspected FPIES trigger is recommended only under supervision at an oral food challenge. Studies continue to evaluate the optimal challenge protocol. Caregivers of children with FPIES report high levels of anxiety and stress, which is attributed to the dramatic symptomatology, dietary restrictions, nutritional concerns, lack of confirmatory diagnostic tests, and limited tools for management of reactions.

Summary

Our understanding of the FPIES diagnosis has improved over the last few decades, but there remain opportunities, particularly regarding discerning the pathophysiology and best management practices.
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Metadata
Title
Update on Food Protein–Induced Enterocolitis Syndrome (FPIES)
Authors
Mary Grace Baker
M. Cecilia Berin
Scott Sicherer
Publication date
06-05-2022
Publisher
Springer US
Keyword
Food Allergy
Published in
Current Allergy and Asthma Reports / Issue 10/2022
Print ISSN: 1529-7322
Electronic ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-022-01037-y