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Food protein-induced enterocolitis syndrome.

Abstract

PURPOSE OF REVIEW

To review current knowledge and recent advances in food protein-induced enterocolitis syndrome (FPIES).

RECENT FINDINGS

Rice is the most common solid food causing FPIES. Rice FPIES is associated with more severe reactions than other foods. Infants presenting acutely may be hypothermic (<36 degrees C) and have thrombocytosis. Finding of hypoalbuminemia and weight gain less than 10 g/day helps to differentiate chronic infantile cow's milk FPIES from infectious causes. Gastric juice leukocytes more than 10 cells per high-power field are found in infants with positive oral food challenge to cow's milk.

SUMMARY

FPIES is a non-IgE-mediated gastrointestinal food hypersensitivity disorder. Food protein-activated intestinal lymphocytes elaborate inflammatory cytokines that result in increased intestinal permeability, malabsorption, dysmotility, emesis, diarrhea, pain, and failure to thrive. Decreased intestinal transforming growth factor beta and increased TNFalpha may be important in FPIES. Cow's milk and soy are the most common causes of FPIES, but cereal grains (rice, oat, and barley), fish, poultry, and vegetables may also cause FPIES. The majority of FPIES resolve by age of 3 years.

Authors+Show Affiliations

Jaffe Food Allergy Institute, Department of Pediatrics, Mount Sinai School of Medicine, Division of Allergy and Immunology, 1 Gustave L. Levy Place, Box 1198, New York, NY 10029, USA. anna.nowak-wegrzyn@mssm.eduNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19474706

Citation

Nowak-Wegrzyn, Anna, and Antonella Muraro. "Food Protein-induced Enterocolitis Syndrome." Current Opinion in Allergy and Clinical Immunology, vol. 9, no. 4, 2009, pp. 371-7.
Nowak-Wegrzyn A, Muraro A. Food protein-induced enterocolitis syndrome. Curr Opin Allergy Clin Immunol. 2009;9(4):371-7.
Nowak-Wegrzyn, A., & Muraro, A. (2009). Food protein-induced enterocolitis syndrome. Current Opinion in Allergy and Clinical Immunology, 9(4), pp. 371-7. doi:10.1097/ACI.0b013e32832d6315.
Nowak-Wegrzyn A, Muraro A. Food Protein-induced Enterocolitis Syndrome. Curr Opin Allergy Clin Immunol. 2009;9(4):371-7. PubMed PMID: 19474706.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Food protein-induced enterocolitis syndrome. AU - Nowak-Wegrzyn,Anna, AU - Muraro,Antonella, PY - 2009/5/29/entrez PY - 2009/5/29/pubmed PY - 2010/1/15/medline SP - 371 EP - 7 JF - Current opinion in allergy and clinical immunology JO - Curr Opin Allergy Clin Immunol VL - 9 IS - 4 N2 - PURPOSE OF REVIEW: To review current knowledge and recent advances in food protein-induced enterocolitis syndrome (FPIES). RECENT FINDINGS: Rice is the most common solid food causing FPIES. Rice FPIES is associated with more severe reactions than other foods. Infants presenting acutely may be hypothermic (<36 degrees C) and have thrombocytosis. Finding of hypoalbuminemia and weight gain less than 10 g/day helps to differentiate chronic infantile cow's milk FPIES from infectious causes. Gastric juice leukocytes more than 10 cells per high-power field are found in infants with positive oral food challenge to cow's milk. SUMMARY: FPIES is a non-IgE-mediated gastrointestinal food hypersensitivity disorder. Food protein-activated intestinal lymphocytes elaborate inflammatory cytokines that result in increased intestinal permeability, malabsorption, dysmotility, emesis, diarrhea, pain, and failure to thrive. Decreased intestinal transforming growth factor beta and increased TNFalpha may be important in FPIES. Cow's milk and soy are the most common causes of FPIES, but cereal grains (rice, oat, and barley), fish, poultry, and vegetables may also cause FPIES. The majority of FPIES resolve by age of 3 years. SN - 1473-6322 UR - https://www.unboundmedicine.com/medline/citation/19474706/Food_protein_induced_enterocolitis_syndrome_ L2 - http://Insights.ovid.com/pubmed?pmid=19474706 DB - PRIME DP - Unbound Medicine ER -