'Diagnosing food protein‐induced enterocolitis syndrome'

Barni, Simona; Vazquez‐Ortiz, Marta; Giovannini, Mattia; Liccioli, Giulia; Sarti, Lucrezia; Cianferoni, Antonella; Mori, Francesca

doi:10.1111/cea.13767

Cited by 14 publications

(19 citation statements)

References 90 publications

(297 reference statements)

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“…Furthermore, since case 1 and case 2 developed fever, leukocytosis, and elevated CRP levels, sepsis was suspected and unnecessarily prolonged antibiotics were used, although the patient’s blood cultures were negative. The differentiations of FPIES and sepsis may include elevated platelet counts ( 22 ), a rapid recovery from shock through rehydration, and family history of allergies. Both case 1 and case 2 had high platelet levels.…”

Section: Discussionmentioning

confidence: 99%

The challenging diagnosis of food protein-induced enterocolitis syndrome: A case report series

2022

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Food protein-induced enterocolitis syndrome (FPIES) is a type of non-immunoglobulin E (IgE)-mediated food allergy. However, in addition to vomiting and diarrhea, IgE-mediated skin or respiratory symptoms may be comorbidities in some patients with FPIES. We described four unusual cases of neonates with FPIES, whose clinical presentations were variable and misleading. All patients experienced vomiting, diarrhea or other gastrointestinal symptoms, and three of them developed IgE-mediated food allergy. Case 1 was admitted to the hospital with convulsions and then developed severe sepsis and necrotizing enterocolitis (NEC)-like appearance. Case 2 was wrongly diagnosed with Stevens–Johnson syndrome due to a severe extravasation rash of the skin and mucous membranes and a systemic inflammatory response. There was unexplained cholestasis in case 3, which might be attributed to food allergy. Asymptomatic elevation of C-reactive protein was the only hint at early-stage FPIES in case 4. Moreover, there were increased serum food-specific IgG values in three of the above cases. After eliminating the offending food, all of the above clinical manifestations rapidly improved in the four cases; thus, we believe that the most correct diagnosis in the described four cases was FPIES. This case report series should further draw clinicians’ attention to FPIES with variable and atypical symptoms. The usefulness of IgG levels in identifying the presence of FPIES is uncertain.

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Section: Discussionmentioning

confidence: 99%

The challenging diagnosis of food protein-induced enterocolitis syndrome: A case report series

2022

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“…FPIES is an non-IgE-mediated disease triggered by some well-known culprit foods causing intestinal disturbances in infants due to local T-cell infiltration and inflammation and imbalanced TNFα/TGFβ response [10]. Our patient presented with a diagnostic of FPIES according to the diagnostic criteria of the International Consensus of FPIES [11].…”

Section: Discussionmentioning

confidence: 99%

Co-Occurrence of Hypohidrotic Ectodermal Dysplasia and Food Protein-Induced Enterocolitis Syndrome: A Report of a New Ectodysplasin A Variant

Salik

Moulart

Marangoni

et al. 2022

Skin Appendage Disord

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Introduction: Ectodermal dysplasias (EDs) are a large group of rare and complex genetic disorders, affecting the development of two or more ectodermal structures. Hypohidrotic ED (HED) is the most frequent ED’s phenotype and is characterized by hypodontia, hypotrichosis, and hypo/anhidrosis, leading to heat intolerance and hyperthermia. Case Presentation: We report a case of a 2-year-old girl with hair and teeth abnormalities associated with severe digestive symptoms responsible for failure to thrive. Genetic analysis by mass sequencing in parallel on a 4,867-gene panel was performed in duo (index case and her mother). The girl showed the presence of a new de novo c.100dupG variant in EDA responsible for HED associated with a diagnosis of food protein-induced enterocolitis syndrome (FPIES). Conclusion: We describe a patient with HED and a new EDA variant associated with a diagnosis of FPIES, both implicating increased intestinal permeability. The inclusion of FPIES as a possible digestive symptom of HED can be suggested, although it may occur only in a context of atopy.

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“…The underlying pathogenesis of this condition is not clearly understood yet, but it is believed to be a non-IgE-mediated reaction to food proteins. Apart from the occasional cases of FPIES associated with IgE-mediated sensitization, skin tests, measurement of specific antibodies, and cell activation tests with the suspected food allergen are mostly inconclusive [66,67]. Considering the lack of validated biomarkers, the diagnosis of FPIES currently relies on fulfilling a set of diagnostic clinical criteria [66].…”

Section: Non-ige Mediated Allergy To Poultrymentioning

confidence: 99%

Poultry Meat allergy: a Review of Allergens and Clinical Phenotypes

Wanniang

Codreanu‐Morel

Kuehn

et al. 2022

Curr Treat Options Allergy

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Purpose of review In the recent years, more cases of poultry meat allergy, both IgE- or non-IgE-mediated, are being reported. Patients have varied clinical reactivity at various levels of sensitivity to different meat preparations. The lack of validated biomarkers renders accurate diagnosis challenging. In this review, we aim to provide an overview of the current status of poultry meat allergy along with a description on the allergens implicated. Recent findings Poultry meat allergy occurs as a result of cross-reactions with known allergens of egg yolk or bird feathers or as genuine IgE-mediated sensitivity to allergens in poultry meat. Individuals can also develop non-IgE-mediated hypersensitivity reactions to poultry meat. Chicken serum albumin is the main responsible allergen in secondary cases, while myosin light chain, α parvalbumin, enolase, aldolase, hemoglobin, and α-actin have been recognized as potential eliciting allergens in genuine poultry meat allergy. Summary There is a wide phenotypic variation among patients with poultry meat allergy, regarding clinical severity and cross-reactivity features. Recognizing the various clinical entities of reactions to poultry meat is an important step towards accurate diagnosis and providing management options that are well received by patients.

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'Diagnosing food protein‐induced enterocolitis syndrome'

Cited by 14 publications

References 90 publications

The challenging diagnosis of food protein-induced enterocolitis syndrome: A case report series

The challenging diagnosis of food protein-induced enterocolitis syndrome: A case report series

Co-Occurrence of Hypohidrotic Ectodermal Dysplasia and Food Protein-Induced Enterocolitis Syndrome: A Report of a New Ectodysplasin A Variant

Poultry Meat allergy: a Review of Allergens and Clinical Phenotypes

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