Food Protein-Induced Enterocolitis Syndrome

Publication date: January 2020Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 8, Issue 1Author(s): Anna Nowak-Wegrzyn, M. Cecilia Berin, Sam MehrFood protein-induced enterocolitis syndrome (FPIES) is a non–IgE-mediated food allergy that manifests with projectile, repetitive emesis that can be followed by diarrhea and may be accompanied by lethargy, hypotonia, hypothermia, hypotension, and metabolic derangements. FPIES usually starts in infancy although onset at older ages is being increasingly recognized. FPIES is not rare, with the cumulative incidence of FPIES in infants estimated to be 0.015% to 0.7%, whereas the population prevalence in the US infants was 0.51%. FPIES diagnosis is challenging and might be missed because of later (1-4 hours) onset of symptoms after food ingestion, lack of typical allergic skin and respiratory symptoms, and food triggers that are perceived to be hypoallergenic. Diagnosis is based on the recognition of symptoms because there are no biomarkers of FPIES. The pathophysiology remains obscure although activation of the innate immune compartment has been detected. Management relies of avoidance of food triggers, treatment of accidental exposures, and periodic re-evaluations with supervised oral food challenges to monitor for resolution. There are no strategies to accelerate development of tolerance in FPIES. Here we review the most important current concepts in epidemiology, pathophysiology, di...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research

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Authors: Mehr S, Campbell DE Abstract Food protein-induced enterocolitis syndrome (FPIES) is a poorly understood non-IgE gastrointestinal-mediated food allergy that predominantly affects infants and young children. Cells of the innate immune system appear to be activated during an FPIES reaction. Acute FPIES typically presents between one and 4 hours after ingestion of the trigger food, with the principal symptom being profuse vomiting, and is often accompanied by pallor and lethargy. Additional features can include hypotension, hypothermia, diarrhoea, neutrophilia and thrombocytosis. In Australia, the most commonl...
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research
ConclusionsOur findings identify C5aR1 activation as an important driver of IgE ‐mediated food allergy through regulation of allergen‐specific IgE production, FcεR1‐mediated MC degranulation, and histamine‐driven effector functions preferentially in male mice.
Source: Allergy - Category: Allergy & Immunology Authors: Tags: Original Article Source Type: research
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Conclusions and Clinical RelevanceA large amount of food additives may prevent acquisition of oral tolerance. Intake of food additives in early life may increase the risk of food allergies.This article is protected by copyright. All rights reserved.
Source: Clinical and Experimental Allergy - Category: Allergy & Immunology Authors: Tags: Original Article ‐Experimental Models of Allergic Disease Source Type: research
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