Differentiation of food protein-induced enterocolitis syndrome and necrotizing enterocolitis in neonates by abdominal sonography

Guo, Yiyi; Si, Shuyu; Jia, Zhifang; Lv, Xiaoming; Wang, Hui

doi:10.1016/j.jped.2020.03.001

Cited by 11 publications

(13 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…FPIES is difficult to differentiate in the early stage of onset and is often misdiagnosed as NEC. Ultrasound findings suggest that PI, portal venous gas (PVG), bowel wall thickening, and weakened/absent intestinal motility can be found in both NEC and FPIES infants (17). Additionally, the radiological finding of PI is not specific to NEC (18).…”

Section: Discussionmentioning

confidence: 99%

Food protein-induced enterocolitis syndrome presenting after necrotizing enterocolitis in a preterm neonate: a case report

Lü

Zhiqun

2021

Transl Pediatr

View full text Add to dashboard Cite

is inflammation of the intestine leading to bacterial invasion causing necrosis of the colon and the intestine (2). As NEC progresses, it can lead to intestinal perforation causing peritonitis, sepsis, and even death. In the clinical setting, approximately half of all infants with NEC respond to bowel rest, antibiotics, and supportive medical measures, but others develop progressive bowel disease and require surgical

show abstract

Section: Discussionmentioning

confidence: 99%

Food protein-induced enterocolitis syndrome presenting after necrotizing enterocolitis in a preterm neonate: a case report

Lü

Zhiqun

2021

Transl Pediatr

View full text Add to dashboard Cite

show abstract

“…There is a lack of large population-based FPIES studies [4] . Unrecognised FPIES results in repeated attacks and chronic symptoms with poor weight gain and failure to thrive [ 6 , 7 ]. Oral food challenges are the gold standard for diagnosis of FPIES, but they are seldom performed in the clinic [5] .…”

Section: Introductionmentioning

confidence: 99%

“…Oral food challenges are the gold standard for diagnosis of FPIES, but they are seldom performed in the clinic [5] . Thus, the current diagnostic criteria for FPIES are primarily based on medical history, clinical manifestations, and symptomatic relief after dietary avoidance [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Firstly, the clinical symptoms of NEC and FPIES, such as vomiting, abdominal distension, diarrhoea, bloody stool, feeding difficulties, sleepiness, apnoea, and shock, might be similar [ 3 , 8 ]. Secondly, in both disorders, patients show intestinal dilatation, pneumatosis intestinalis, and portal venous gas on radiographs or ultrasound [ 5 , 7 ]. However, the prognosis and therapies for NEC and FPIES are vastly different [ 5 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Secondly, in both disorders, patients show intestinal dilatation, pneumatosis intestinalis, and portal venous gas on radiographs or ultrasound [ 5 , 7 ]. However, the prognosis and therapies for NEC and FPIES are vastly different [ 5 , 7 ]. NEC cases tend to experience rapid escalation of symptoms, much poorer prognosis, and need a much longer duration of antibiotics and fasting, whereas FPIES requires only dietary modification [ 5 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

IL-27 as a potential biomarker for distinguishing between necrotising enterocolitis and highly suspected early-onset food protein-induced enterocolitis syndrome with abdominal gas signs

Liu

Zhong

et al. 2021

eBioMedicine

View full text Add to dashboard Cite

Background: The initial clinical manifestations and abdominal imaging findings of neonates with necrotising enterocolitis (NEC) and food protein-induced enterocolitis syndrome (FPIES) are sometimes similar; however, their prognosis and therapies are different. We aimed to evaluate the utility of interleukin (IL)-27 as a differentiation marker between NEC and highly suspected early onset (HSEO)-FPIES. Methods: All samples used in this study were obtained from the neonatal diagnosis centre of Children's Hospital of Chongqing Medical University. In the case-control study, neonates with NEC (n = 13), HSEO-FPIES (n = 9), and jaundice (control, n = 8) were enroled to determine the serum IL-27 levels using commercial enzyme-linked immunosorbent assay (ELISA) kits. In the validation cohort study, the NEC (n = 87), HSEO-FPIES (n = 62), and jaundice (control, n = 54) groups were included to analyse the diagnostic efficiency of IL-27 for discriminating between NEC and HSEO-FPIES using a receiver operating characteristic (ROC) curve. Findings: In the case-control study, IL-27 levels were higher in the NEC group than in the HSEO-FPIES group (p = 0¢005). In the cohort study, the area under the ROC curve (AUC) of IL-27 for differentiating NEC from HSEO-FPIES was 0¢878, which was higher than the AUCs of IL-6 (0¢761), C-reactive protein (0¢800), white blood cell count (0¢637), neutrophils (0¢765), lymphocytes (0¢782), neutrophil to lymphocyte ratio (0¢781), and platelet count (0¢729). Interpretation: Serum IL-27 is a novel biomarker that may potentially discriminate NEC from HSEO-FPIES in neonates.

show abstract

Food protein‐induced enterocolitis syndrome with pneumatosis intestinalis in an exclusively breastfed infant: A case report and literature review

Almeida

Vásconez-Muñoz

Vásconez-Montalvo

et al. 2022

Clinical Case Reports

View full text Add to dashboard Cite

Food protein-induced enterocolitis syndrome (FPIES) is a gastrointestinal, non-IgE mediated, and food hypersensitivity syndrome, and particularly occurs in infants during the introduction of new foods. There is no specific diagnostic test for FPIES, and therefore, diagnosis relies on medical records, symptoms presented, oral food challenges, and symptomatic relief after dietary avoidance. 1 Contrastingly, necrotizing enterocolitis (NEC) is a lifethreatening emergency of the gastrointestinal tract that almost exclusively affects newborns, with 70% of these cases occurring in preterm infants (<36 weeks of gestation). 2 This condition warrants treatment with broad-spectrum antibiotics, bowel rests, inotropes, and fluid support. 3 The diagnosis of FPIES can be challenging, as its clinical manifestations may mimic other diseases such as NEC, leading to misdiagnosis. Symptoms that arise in both conditions include vomiting, abdominal distention, diarrhea, bloody stools, feeding difficulties, lethargy, apnea, and shock. Additionally, in both conditions, diagnostic tests, such as abdominal radiography, may show intestinal dilatation, pneumatosis intestinalis (PI), and portal venous gas. 4 We present a case of FPIES in a 1-month-old, exclusively breastfed male, initially diagnosed with NEC, showing persistent PI on radiography and metabolic acidosis in the venous blood gas test. Our objective was to highlight the diagnostic difficulties associated with FPIES in exclusively breastfed infants. | CLINICAL CASEThe patient was a 1-month-old male, born at 38 + 6 weeks of gestation, with a history of transient tachypnea (requiring oxygen for less than 24 h) and a patent foramen ovale. He had no personal or family history of allergic conditions

show abstract

Differentiation of food protein-induced enterocolitis syndrome and necrotizing enterocolitis in neonates by abdominal sonography

Cited by 11 publications

References 18 publications

Food protein-induced enterocolitis syndrome presenting after necrotizing enterocolitis in a preterm neonate: a case report

Food protein-induced enterocolitis syndrome presenting after necrotizing enterocolitis in a preterm neonate: a case report

IL-27 as a potential biomarker for distinguishing between necrotising enterocolitis and highly suspected early-onset food protein-induced enterocolitis syndrome with abdominal gas signs

Food protein‐induced enterocolitis syndrome with pneumatosis intestinalis in an exclusively breastfed infant: A case report and literature review

Contact Info

Product

Resources

About