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Erschienen in: Current Allergy and Asthma Reports 10/2022

06.05.2022 | Pediatric Allergy and Immunology (W Dolen, Section Editor)

Update on Food Protein–Induced Enterocolitis Syndrome (FPIES)

verfasst von: Mary Grace Baker, M. Cecilia Berin, Scott Sicherer

Erschienen in: Current Allergy and Asthma Reports | Ausgabe 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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Metadaten
Titel
Update on Food Protein–Induced Enterocolitis Syndrome (FPIES)
verfasst von
Mary Grace Baker
M. Cecilia Berin
Scott Sicherer
Publikationsdatum
06.05.2022
Verlag
Springer US
Erschienen in
Current Allergy and Asthma Reports / Ausgabe 10/2022
Print ISSN: 1529-7322
Elektronische ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-022-01037-y

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