Metabolic acidosis as Food Protein Induced Enterocolitis Syndrome (FPIES) onset in a newborn

Abstract

BackgroundFPIES (Food Protein Induced Eneterolitis Syndrome) is a rare non IgE- mediated food allergy, usually affecting infants and children after first months of life. Clinical presentation is heterogeneous, usually characterised by repetitive vomiting and diarrhoea, lethargy, failure to thrive until to dehydration with hypotension and shock. The diagnosis is based on clinical criteria, after excludind other hypothetical conditions. Early recognition of FPIES is essential to set a correct dietatay management that is resolving for the patient.Case reportWe present the case of a 12 days old child who was admitted to the hospital for poor feeding, failure to thrive and severe metabolic acidosis.ConclusionsThe early onset of this case is peculiar and rember us to consider FPIES in differential diagnosis of newborn metabolica acidosis.

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] . The condition can present with variable symptoms, including abdominal distention, vomiting, diarrhea, constipation, and bloody stools, whereas the nonspecific symptoms include poor weight gain, fever, and apnea.…”

Food protein‐induced enterocolitis syndrome with pneumatosis intestinalis in an exclusively breastfed infant: A case report and literature review

“…Although no laboratory tests are needed to diagnose acute FPIES, they can reveal neutrophilia, thrombocytosis, anemia, hypoalbuminemia, eosinophilia, metabolic acidosis, methemoglobinemia, and stool leukocytes or eosinophils 5,15,16,17,18 …”

“…1 Although no laboratory tests are needed to diagnose acute FPIES, they can reveal neutrophilia, thrombocytosis, anemia, hypoalbuminemia, eosinophilia, metabolic acidosis, methemoglobinemia, and stool leukocytes or eosinophils. 5,15,16,17,18 Imaging studies are not necessary to diagnose FPIES, although findings of intestinal dilatation, PI, and PVG 4 could be present on both radiography and in patients with NEC. It is essential to mention that PI is not a primary disease, but rather a clinical sign, 19 nor is it a pathognomonic of any specific disease.…”