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Case Reports in Pediatrics
Volume 2016, Article ID 1621827, 5 pages
http://dx.doi.org/10.1155/2016/1621827
Case Report

FPIES: Reviewing the Management of Food Protein-Induced Enterocolitis Syndrome

1Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage SG1 4AB, UK
2Department of Immunology, School of Medicine, Moi University, P.O. Box 4606, Eldoret 30100, Kenya

Received 17 September 2015; Accepted 28 January 2016

Academic Editor: Ozgur Cogulu

Copyright © 2016 Neha Khanna and Kirtika Patel. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose of Review. The aim of this review is to provide a case driven presentation of the presenting features and diagnostic criteria particularly focusing on the management of FPIES. It also summarises the natural history and resolution of cow’s milk induced FPIES. Data Sources. OvidSP Database was used to search for literature using the keywords food protein-induced enterocolitis and FPIES. Recent Findings. The diagnosis of FPIES is often delayed following two or more presentations. Symptoms in the acute form include profuse vomiting usually 2–6 hours following ingestion of food. Vomiting may or may not be accompanied by diarrhoea. Management involves removing the causal food protein from diet. There is some concomitance in cow’s milk and soya induced FPIES. Hence extensively hydrolysed formula is the milk of choice unless breast-feeding is carried out in which case that should be continued. Summary. FPIES is a complex form of non-IgE mediated food allergy. More awareness and knowledge of the condition are required to prevent misdiagnosis. Early diagnosis and removal of the culprit food protein improve the outcome. Good nutritional advice and clear management plans are important. More multicentre studies are required to reevaluate and produce consistent oral food challenge criteria and guidelines.