Criteria for the suspicion and diagnosis of acute food protein-induced enterocolitis syndrome

Main Article Content

Stefano Miceli Sopo

Keywords

diagnosis, food allergy, food protein-induced enterocolitis syndrome, oral food challenge, suspicion

Abstract

Over the past decades, several panels of criteria have been proposed for the diagnosis of acute food protein-induced enterocolitis syndrome (FPIES). However, none of them have been validated by a prospective study. Such a study is not easy to carry out, because even the children who most of us would certainly believe to be suffering from acute FPIES, possibly serious, should be subject to oral food challenge (OFC). Moreover, the presence of different phenotypes of the acute FPIES may mean that some of them do not fit into any of the above criteria panels. Particularly, Vazquez-Ortiz et al. reported that milder cases (1/4 in their Southern European cohort) might not be captured by the 2017 Consensus diagnostic criteria, which are the most shared till date. Those authors, as well as all interested researchers, claim for accurate diagnostic bio-markers which, however, are not available at the moment.

Abstract 161 | PDF Downloads 131 XML Downloads 0 HTML Downloads 35

References

1. Sicherer SH, Eigenmann PA, Sampson HA. Clinical features of food protein-induced enterocolitis syndrome. J Pediatr. 1998;133:214– 219. https://doi.org/10.1016/S0022-3476(98)70222-7

2. Leonard SA, Nowak-Węgrzyn A. Clinical diagnosis and management of food protein-induced enterocolitis syndrome. Curr Opin Pediatr. 2012;24:739–745. https://doi.org/10.1097/ MOP.0b013e3283599ca1

3. Miceli Sopo S, Greco M, Monaco S, Tripodi S, Calvani M. Food protein-induced enterocolitis syndrome, from practice to theory. Expert Rev Clin Immunol. 2013;9:707–715. https://doi.org/ 10.1586/1744666X.2013.814418

4. Lee E, Campbell DE, Barnes EH, Mehr SS. Resolution of acute food protein-induced enterocolitis syndrome in children. J Allergy Clin Immunol Pract. 2017;5:486.e1–488.e1. https://doi.org/10.1016/j.jaip.2016.09.032

5. Nowak-Węgrzyn A, Chehade M, Groetch ME, Spergel JM, Wood RA, Allen K, et al. International consensus guidelines for the diagnosis and management of food protein-induced enterocolitis syndrome: executive summary-Workgroup Report of the Adverse Reactions to Foods Committee, American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol. 2017;139:1111–1126. https://doi.org/10.1016/j.jaci.2016.12.966

6. Miceli Sopo S, Bersani G, Fantacci C, Romano A, Monaco S. Diagnostic criteria for acute food protein induced enterocolitis syndrome. Is the work in progress? Allergol Immunopathol. 2018;46(6):607–611. https://doi.org/10.1016/j.aller.2017.09.033

7. Miceli Sopo S, Gelsomino M, Rivetti S, Del Vescovo E. Food protein-induced enterocolitis syndrome: proposals for new definitions. Medicina (Kaunas). 2019;55(pii):E216. https://doi. org/10.3390/medicina55060216

8. Vazquez-Ortiz M, Argiz L, Machinena A, Echeverria L, Blasco C, Prieto A, et al. Diagnostic criteria for acute FPIES: What are we missing? J Allergy Clin Immunol Pract. 2019;9(pii):S2213-2198(19)31016-5. https://doi:10.1016/j. jaip.2019.11.034.

9. Miceli Sopo S, Bersani G, Monaco S, Cerchiara G, Lee E, Campbell D, et al. Ondansetron in acute food protein-induced enterocolitis syndrome, a retrospective case-control study. Allergy. 2017;72:545–551. https://doi.org/10.1111/all.13033