Medico e Bambino
2012
Maggio 2012
numero 5
PERCORSI CLINICI




La FPIES (Food Protein-Induced Enterocolitis Syndrome)

Ines L’Erario1, Domenica Giglia1, Margherita Londero1, Laura Badina2, Paola Moras3, Maria Francesca Pasquale3, Giorgio Longo2
1Scuola di Specializzazione in Pediatria, IRCCS Pediatrico “Burlo Garofolo”, Università di Trieste
2SS di Allergologia e Trattamento dell’asma, Clinica Pediatrica, IRCCS Pediatrico “Burlo Garofolo”, Trieste
3Pediatria dell’Ospedale “S. Maria di Ca’ Foncello”, Treviso

indirizzo per corrispondenza:giorgio.longo@burlo.trieste.it

Food Protein-Induced Enterocolitis Syndrome (FPIES):
Key words
Food Protein-Induced Enterocolitis Syndrome (FPIES), Anaphylactic vomiting, Food allergy

Summary
Food Protein-Induced Enterocolitis Syndrome (FPIES) is an uncommon and potentially severe form of non-IgE-mediated food allergy. Two clinically distinct forms have been reported. In the chronic or early form symptoms typically begin in the first month of life, while the antigen is being ingested on a regular basis, with chronic diarrhoea and intermittent vomiting, in association with failure to thrive. In the acute or late form symptoms may occur at an older age with profuse, repetitive vomiting, often with diarrhoea, that leads to acute dehydration, lethargy and, in the most severe cases, shock and hypotension. The acute manifestations usually start two or more hours after the ingestion of the offending food. FPIES is typically caused by milk or soy in formula-fed infants, but may also be triggered by ingestion of solid foods such as rice, oat, barley, fish, and others. Frequently children with FPIES reacted to more than one food. The majority of patients have negative skin prick tests and undetectable food-specific IgE, thus the diagnosis of FPIES is usually made on a clinical basis. The pathophysiology is still unclear; however FPIES seems to be a cell-mediated immunologic disorder in which TNF-alfa may play a key role. For the acute phase, treatment with intravenous hydration is often needed. Avoidance of the trigger food protein/s is currently the only effective treatment option, however most children will outgrow their FPIES by about three to five years of age. Early recognition of FPIES remains a critical issue to prevent misdiagnosis and mismanagement of symptoms that may mimic other causes.


Vuoi citare questo contributo?
I. L’Erario, D. Giglia, M. Londero, L. Badina, P. Moras, M.F. Pasquale, G. Longo. LA FPIES (FOOD PROTEIN-INDUCED ENTEROCOLITIS SYNDROME). Medico e Bambino 2012;31:298-306 https://www.medicoebambino.com/?id=1205_298.pdf






L'accesso è riservato agli abbonati alla rivista che si siano registrati.
Per accedere all'articolo in formato full text è necessario inserire username e password.




La riproduzione senza autorizzazione è vietata. Le informazioni di tipo sanitario contenute in questo sito Web sono rivolte a personale medico specializzato e non possono in alcun modo intendersi come riferite al singolo e sostitutive dell'atto medico. Per i casi personali si invita sempre a consultare il proprio medico curante. I contenuti di queste pagine sono soggetti a verifica continua; tuttavia sono sempre possibili errori e/o omissioni. Medico e Bambino non è responsabile degli effetti derivanti dall'uso di queste informazioni.

Unauthorised copies are strictly forbidden. The medical information contained in the present web site is only addressed to specialized medical staff and cannot substitute any medical action. For personal cases we invite to consult one's GP. The contents of the pages are subject to continuous verifications; anyhow mistakes and/or omissions are always possible. Medico e Bambino is not liable for the effects deriving from an improper use of the information.