t AN OVERVIEW ON “FOOD PROTEIN-INDUCED ENTEROCOLITIS
SYNDROME”
B.ARUNA SRI ,E.ANITHA REDDY
SREE CHAITANYA INSTITUTE OF PHARMACEUTICAL SCIENCES
ABSTRACT
The most common triggers for FPIES are:
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-
mediated food allergy that has been well-characterized clinically, yet it is • Food proteins: Common triggers include cow's milk, soy, rice,
still poorly understood. Acute FPIES is characterized by vomiting 1-4 h oats, and some fruits or vegetables. However, virtually any food
and/or diarrhea within 24 h after ingestion of a culprit food. Chronic can cause FPIES in susceptible individuals.
FPIES is the result of chronic exposure to an offending food that can • Genetic factors:There may be a genetic predisposition to developing
result in chronic watery diarrhea, intermittent vomiting, and failure to FPIES, as it tends to run in families with a history of other types of
thrive. FPIES typically presents in infancy and self-resolves by school allergies, like asthma or eczema.
age in most patients. Adult-onset FPIES is rare, but it has been reported. • Immune system dysfunction: FPIES is thought to involve an
Cow’s milk and soy are the most common triggering foods in infants in abnormal immune response, in which the body mistakenly
the US, and as solids are introduced in the diet, FPIES reactions to grains reacts to normally harmless food proteins.
(rice,oat) increase in prevalence. Variability in common trigger foods
exists depending on the geographical origin- for example, fish is a
frequent trigger in Spanish and Italian patients. Heavy reliance on a
detailed history is required for the diagnosis as physical exam findings,
laboratory tests, and/or imaging studies are suggestive and not specific
for FPIES.
The recent development of diagnostic criteria in 2017 will serve to
increase recognition of the disorder and allow for early
implementation of management strategies. Acute management during
reactions includes IV hydration, anti-emetics, and IV corticosteroids.
Reaction prevention strategies include strict food avoidance until the
physician deems a food reintroduction challenge clinically
appropriate. Future efforts in FPIES research should be aimed at
elucidating the underlying disease mechanisms and possible treatment
targets Diagnosis of FPIES:
THEORY • Clinical History:
WHAT IS FPIES?
• A key component in diagnosing FPIES is obtaining a thorough clinical
FPIES stands for Food Protein-Induced Enterocolitis Syndrome, which is history. The symptoms usually occur after the ingestion of specific
a rare but severe form of food allergy that primarily affects infants and foods, often between 1 to 4 hours after consumption.
young children. It is a non-IgE-mediated food allergy, meaning it does • Exclusion of Other Conditions:
not involve the typical IgE antibodies that are associated with most food
– Diagnosis of FPIES is primarily clinical. Other potential causes
allergies Instead, FPIES involves a delayed immune response, typically
for similar symptoms, such as infections or other gastrointestinal
causing gastrointestinal
disorders, must be ruled out.
Pathophysiology of FPIES: Treatment: FPIES reactions are managed by giving fluids to maintain
Immune Response: Unlike typical IgE-mediated food allergies, hydration. In some cases, on dansetron wafers (a medication that dissolves
which involve an immediate hypersensitivity reaction, FPIES is a in the mouth) are prescribed to help stop vomiting. In cases where the
cell-mediated response. The immune system reacts to food vomiting is very bad and the child is pale and floppy, intravenous fluids
proteins through T-cells, leading to an inflammatory response in may be needed.
the gastrointestinal tract. CONCLUSION
Inflammation of the Gastrointestinal Tract: In FPIES, the FPIES(Food Protein-Induced Enterocolitis Syndrome)is a rare, non-Ig
body's immune system triggers an inflammatory response in the Emediated food allergy that affects infants and young children. It causes
intestines, particularly the stomach and small bowel. This leads to delayed gastrointestinal symptoms like vomiting and diarrhea, triggered by
symptoms such as vomiting, diarrhea, and sometimes bloody specific foods such as cow's milk or soy. The condition is characterized by a
stools, often within a few hours of ingesting the trigger food. T- cell mediated immune response, not IgE involvement. Treatment involves
avoiding trigger foods and providing supportive care during acute episodes.
Many children outgrow FPIES with time, but proper management is crucial to
prevent severe reactions
REFERENCES
The references used are :
journal of allergy and clinical immunology
“Food protein induced enterocolitis syndrome: A handbook for diagnosis and
management “ by jarvinen KM,Nowak wegrzyn
ACKNOWLEDGMENT
I would like to extend my sincere gratitude to E.ANITHA REDDY Mam for
her guidance and support in the development of the poster presentation.
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