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Expert Rev Clin Immunol. 2013 Aug;9(8):707-15. doi: 10.1586/1744666X.2013.814418.

Food protein-induced enterocolitis syndrome, from practice to theory.

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Department of Paediatrics, Catholic University of Sacred Heart, L.go Gemelli 8, Rome 00168, Italy.


Food protein-induced enterocolitis syndrome (FPIES) is an allergic disease, probably non-IgE-mediated, with expression predominantly in the GI tract. The most characteristic symptom is repeated, debilitating vomiting. It occurs 2-6 h after ingestion of culprit food and is usually accompanied by pallor and lethargy. There may be diarrhea, and in 10-20% of cases, severe hypotension. These symptoms resolve completely within a few hours. The food most frequently involved is cow's milk, followed by rice, but many other foods may be involved. The prognosis is generally good in a few years. In this review the authors try to cope, with the help of some case histories, with the practical clinical aspects of FPIES. The authors also try to provide a management approach based on current knowledge, and finally, to point out the aspects of FPIES that are still controversial.

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