Food Protein–Induced Enterocolitis Syndrome Food Challenges: Experience from a Large Referral Center

Wang, Kathleen Y.; Lee, Ju Hee; Cianferoni, Antonella; Ruffner, Melanie A.; Dean, Amy B.; Molleston, Jerome M.; Pawlowski, Nicholas A.; Heimall, Jennifer; Saltzman, Rushani; Ram, Gita; Fiedler, Joel; Gober, Laura; Spergel, Jonathan M.; Brown-Whitehorn, Terri F.

doi:10.1016/j.jaip.2018.09.009

Cited by 62 publications

(46 citation statements)

References 14 publications

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“…Since acute FPIES typically starts within the first year of life (commonly within the first 6 months), usually following few feedings with the food, the common reported triggers reflect the first few foods introduced into the infant diet. Of note, new onset of FPIES is rare if the food is introduced into the diet after the 1st birthday …”

Section: Epidemiologymentioning

confidence: 99%

“…Data from a population‐based birth cohort (with a spectrum of severity), suggested that mild reactions could be treated with oral rehydration . Risk factors predicting a severe reaction during OFC has not been well defined . Thus, in the international guidelines, home OFC is not recommended in patients with prior severe reactions, and secure peripheral intravenous access is advisable to provide intravenous hydration in case of severe reactions .…”

Section: Different Phenotypes Of Food Protein‐induced Enterocolitis Smentioning

confidence: 99%

“…58 Indeed, FPIES is considered a high-risk procedure as a large proportion of patients will need intravenous fluid administration, and some develop severe reaction with hypotension. 11,20,26 Data from a population-based birth cohort (with a spectrum of severity), suggested that mild reactions could be treated with oral rehydration. 6 Risk factors predicting a severe reaction during OFC has not been well defined.…”

Section: Diagnosis and Role Of Oral Food Challengementioning

confidence: 99%

“…6 Risk factors predicting a severe reaction during OFC has not been well defined. 20 Thus, in the international guidelines, home OFC is not recommended in patients with prior severe reactions, and secure peripheral intravenous access is advisable to provide intravenous hydration in case of severe reactions. 3 We propose that in patients with prior mild reactions to (Table 1).…”

Section: Diagnosis and Role Of Oral Food Challengementioning

confidence: 99%

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Food protein‐induced enterocolitis syndrome

Caubet

Cianferoni

Groetch

et al. 2019

Clin Experimental Allergy

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Food protein‐induced enterocolitis syndrome (FPIES) is a non‐IgE‐mediated gastrointestinal food allergic disorder that has gained a major interest the past decade. FPIES prevalence, which still needs to be accurately determine in different populations, appears to be higher than previously thought (ie up to 0.7% in infants in the 1st year of life). FPIES to seafood in adults is also increasingly reported; limited data suggest that adult FPIES is most commonly triggered by shellfish, tends to affect females more than men, is characterized by a significant delay in diagnosis and a prolonged course. The first international consensus guidelines on diagnosis and management of FPIES have been published in 2017, proposing new diagnostic criteria as well as new criteria for a positive oral food challenge. However, there is a need to develop new biomarkers to improve the diagnosis and management of FPIES patients, and this requires a better understanding of the pathophysiology. Recently, the role of T cells has been questioned and a major role of innate immune cells has been suggested in acute FPIES. Regarding the treatment of acute FPIES reaction, ondansetron has emerged as an adjunct to intravenous rehydration in moderate‐severe reactions and as a first‐line treatment in mild reactions. Important information regarding the nutritional management of FPIES patients that might be complex has also been provided in the international guidelines. In this review, we discuss recent advances regarding all those different aspects.

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Section: Epidemiologymentioning

confidence: 99%

Section: Different Phenotypes Of Food Protein‐induced Enterocolitis Smentioning

confidence: 99%