Histopathological evaluation of food protein‐induced enterocolitis syndrome

Necrotizing enterocolitis associated with food protein-induced enterocolitis syndrome: A case report

“…FPIES is a T-cell-mediated allergy that occurs in newborns and infants [2] . The pathophysiology of FPIES is not well known, but it has been hypothesized that an abnormal cell-mediated immunological disorder of gastrointestinal mucositis after ingestion of a trigger food, which is often cow's milk or soybean formula but can potentially be any food (fish, egg, wheat, rice, meat, fruit, and vegetables) [7] , [8] , [9] .…”

“…Guo reported that abdominal ultrasound can be used to differentiate between necrotizing enterocolitis and FPIES in the early stages [11] . Histopathological evaluation of the ileal mucosa, according to Kataoka, will be useful in clarifying the pathology of FPIES and its early diagnosis, particularly in surgical cases [2] . In our case, the allergen-specific lymphocyte stimulation test with lactotransferrin was positive, indicating that the primary condition was FPIES.…”

“…Food protein-induced enterocolitis syndrome ( FPIES ) is a non-immunoglobulin E ( IgE )-mediated food allergy that can cause not only digestive symptoms, including abdominal distention, vomiting, diarrhea, constipation, and bloody stools, but FPIES can also cause nonspecific symptoms, including poor weight gain, fever, and apnea [1] , [2] . Although FPIES currently can only be diagnosed clinically, acute FPIES manifests within 1–4 h after ingestion of the causative food and is accompanied by repetitive emesis, pallor, and lethargy progressing to dehydration and hypovolemic shock in 15 % of cases [3] .…”

Fetal ascites as a possible sign of food protein‐induced enterocolitis syndromes

“…[1][2][3][4] As fetuses are exposed to food allergens contained in the mother's diet, 5 sensitization may occur in the fetal period and there have been accumulating case reports of neonatal FPIES where the fetus was considered to have been sensitized in utero. [1][2][3] Ichimura et al reported a preterm case presenting with significant fetal intestinal distension, suggesting "fetal onset" of FPIES. 2 In our preterm case, massive fetal ascites was noted, which disappeared with continuous peritoneal drainage and bowel rest after birth.…”

“…Food protein-induced enterocolitis syndrome is predominantly a non-IgE-mediated disease of young infants, characterized by non-specific symptoms, such as vomiting, watery/ bloody stool, abdominal distension, and ascites, which progresses to hypotension, hypothermia, and metabolic acidosis in severe cases. [1][2][3][4] As fetuses are exposed to food allergens contained in the mother's diet, 5 sensitization may occur in the fetal period and there have been accumulating case reports of neonatal FPIES where the fetus was considered to have been sensitized in utero. [1][2][3] Ichimura et al reported a preterm case presenting with significant fetal intestinal distension, suggesting "fetal onset" of FPIES.…”