Percorsi clinici
La FPIES (Food Protein-Induced Enterocolitis Syndrome)
Food Protein-Induced Enterocolitis Syndrome (FPIES):
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”, Universitŕ 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
Maggio 2012 - pagg. 298 -306
Abstract
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.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
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Corrispondenza: giorgio.longo@burlo.trieste.it