Food Protein-Induced Enterocolitis Syndrome (FPIES) is a non-IgE mediated delayed hypersensitivity to food. It presents in infancy usually under 9 months of age and spontaneously resolves within 2 years and is often confused with infantile colic, gastroenteritis or septicaemia. Typical features include vomiting, pallor, lethargy and diarrhoea. These attacks tend to occur about 2 hours after certain feeds. The most common trigger is cow’s milk protein (cows milk protein intolerance CMPI), which is implicated in 65% of all cases, other foods less often implicated include egg, grains, soy, fish and banana. Symptoms are usually reproducible after ingesting the trigger food and diagnosis is made on a positive food challenge test. There are no accurate diagnostic skin or blood tests, but infants with this condition usually have inflammatory eosinophil and neutrophil cells in their stool sample as well as gastric juices during an attack.
Miceli Sopo et al. A multicentre retrospective study of 66 Italian children with food protein-induced enterocolitis syndrome: different management for different phenotypes. Clinical & Experimental Allergy 2012 (42) 1257-1265
