Food protein-induced enterocolitis syndrome - Revision history

Ostermayer: Prepared the page for translation

2026-01-04T22:55:07Z

Prepared the page for translation

← Older revision		Revision as of 22:55, 4 January 2026
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			<languages/>
			<translate>

	==Background==		==Background==

	*Non-IgE mediated immune reaction to food protein		*Non-IgE mediated immune reaction to food protein
	*Peak incidence in infants 0-9 months		*Peak incidence in infants 0-9 months
	*Cow's milk and soy (in patient's diet or maternal diet if breast fed) are most common culprits		*Cow's milk and soy (in patient's diet or maternal diet if breast fed) are most common culprits


	==Clinical Features==		==Clinical Features==

	*Acute reactions can cause life-threatening volume depletion		*Acute reactions can cause life-threatening volume depletion
	**Onset of symptoms ~1-6 hours after ingesting culprit (possibly reintroduced after period of not consuming)		**Onset of symptoms ~1-6 hours after ingesting culprit (possibly reintroduced after period of not consuming)
	**Profuse, repetitive [[nausea and vomiting (peds)\|vomiting]] and voluminous [[diarrhea (peds)\|diarrhea]]		**Profuse, repetitive [[Special:MyLanguage/nausea and vomiting (peds)\|vomiting]] and voluminous [[Special:MyLanguage/diarrhea (peds)\|diarrhea]]
	**Can lead to profound [[dehydration (peds)\|dehydration]], [[shock]], severe [[electrolyte abnormalities]]		**Can lead to profound [[Special:MyLanguage/dehydration (peds)\|dehydration]], [[Special:MyLanguage/shock\|shock]], severe [[Special:MyLanguage/electrolyte abnormalities\|electrolyte abnormalities]]
	**75% of infants with FPIES appear seriously ill, with ~15% requiring hospitalization for hypotension<ref>Nowak-wegrzyn A, Muraro A. Food protein-induced enterocolitis syndrome. Curr Opin Allergy Clin Immunol. 2009;9(4):371-7.</ref>		**75% of infants with FPIES appear seriously ill, with ~15% requiring hospitalization for hypotension<ref>Nowak-wegrzyn A, Muraro A. Food protein-induced enterocolitis syndrome. Curr Opin Allergy Clin Immunol. 2009;9(4):371-7.</ref>
	*Symptoms may be mild-moderate if chronically exposed to offending food		*Symptoms may be mild-moderate if chronically exposed to offending food
	**Chronic watery [[diarrhea (peds)\|diarrhea]] with blood or mucus, [[nausea and vomiting (peds)\|vomiting]], [[failure to thrive (peds)\|failure to thrive]]		**Chronic watery [[Special:MyLanguage/diarrhea (peds)\|diarrhea]] with blood or mucus, [[Special:MyLanguage/nausea and vomiting (peds)\|vomiting]], [[Special:MyLanguage/failure to thrive (peds)\|failure to thrive]]


	==Differential Diagnosis==		==Differential Diagnosis==

			</translate>
	{{n/v peds newborn}}		{{n/v peds newborn}}
			<translate>

			</translate>
	{{n/v peds infant}}		{{n/v peds infant}}
			<translate>

	*Overfeeding		*Overfeeding
	*Starvation stools		*Starvation stools
	*Short bowel syndrome		*Short bowel syndrome
	*[[Cystic fibrosis]]		*[[Special:MyLanguage/Cystic fibrosis\|Cystic fibrosis]]
	*[[Celiac disease]]		*[[Special:MyLanguage/Celiac disease\|Celiac disease]]
	*Disaccharidase deficiency		*Disaccharidase deficiency
	*Secretory neoplasms		*Secretory neoplasms
	*Immunodeficiency		*Immunodeficiency
	*[[Inflammatory bowel disease]]		*[[Special:MyLanguage/Inflammatory bowel disease\|Inflammatory bowel disease]]
	*[[Antibiotic]]-associated diarrhea		*[[Special:MyLanguage/Antibiotic\|Antibiotic]]-associated diarrhea
	*[[neonatal abstinence syndrome\|Neonatal drug withdrawal]]		*[[Special:MyLanguage/neonatal abstinence syndrome\|Neonatal drug withdrawal]]
	*[[Toxins]]		*[[Special:MyLanguage/Toxins\|Toxins]]
	*[[Hemolytic uremic syndrome]]		*[[Special:MyLanguage/Hemolytic uremic syndrome\|Hemolytic uremic syndrome]]


	==Evaluation==		==Evaluation==

	*Clinical diagnosis		*Clinical diagnosis
	*Labs to assess for consequences of GI losses (e.g. BMP, Mg/Phos, [[VBG]]) +/- workup to exclude alternative diagnoses		*Labs to assess for consequences of GI losses (e.g. BMP, Mg/Phos, [[Special:MyLanguage/VBG\|VBG]]) +/- workup to exclude alternative diagnoses


	==Management==		==Management==

	*Remove offending agent from diet (and maternal diet if patient breastfed)		*Remove offending agent from diet (and maternal diet if patient breastfed)
	*Volume resuscitation (see: [[dehydration (peds)]])		*Volume resuscitation (see: [[Special:MyLanguage/dehydration (peds)\|dehydration (peds)]])
	*Correct [[electrolyte abnormalities]]		*Correct [[Special:MyLanguage/electrolyte abnormalities\|electrolyte abnormalities]]
	*[[Antiemetics]] prn		*[[Special:MyLanguage/Antiemetics\|Antiemetics]] prn
	*If severe<ref>Current Treatment Options in Allergy. Jarock-Cyrta E, Valverde-Monge M, Nowak-Wegrzyn A. Management of Food Protein-Induced Enterocolitis Syndrome (FPIES): Current Approach and Future Needs. Current Treatment Options in Allergy 2017; 4:383</ref> (e.g. intractable vomiting, ill-appearing, lethargic, hypotensive)		*If severe<ref>Current Treatment Options in Allergy. Jarock-Cyrta E, Valverde-Monge M, Nowak-Wegrzyn A. Management of Food Protein-Induced Enterocolitis Syndrome (FPIES): Current Approach and Future Needs. Current Treatment Options in Allergy 2017; 4:383</ref> (e.g. intractable vomiting, ill-appearing, lethargic, hypotensive)
	**[[Methylprednisolone]] 1mg/kg IV		**[[Special:MyLanguage/Methylprednisolone\|Methylprednisolone]] 1mg/kg IV
	**[[Epinephrine]] 0.01 mg/kg IM if shock/hypotension refractory to IV fluids		**[[Special:MyLanguage/Epinephrine\|Epinephrine]] 0.01 mg/kg IM if shock/hypotension refractory to IV fluids


	==Disposition==		==Disposition==

	*Admit if requires IV rehydration, electrolyte abnormalities, or intractable symptoms		*Admit if requires IV rehydration, electrolyte abnormalities, or intractable symptoms


	==See Also==		==See Also==
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	==References==		==References==

	<references/>		<references/>

	[[Category:Pediatrics]]		[[Category:Pediatrics]]
	[[Category:GI]]		[[Category:GI]]
			</translate>

Mtjordan91: /* Differential Diagnosis */

2019-11-21T23:13:00Z

Differential Diagnosis

← Older revision		Revision as of 23:13, 21 November 2019
Line 22:		Line 22:
	*Short bowel syndrome		*Short bowel syndrome
	*[[Cystic fibrosis]]		*[[Cystic fibrosis]]
	*Celiac disease		*[[Celiac disease]]
	*Disaccharidase deficiency		*Disaccharidase deficiency
	*Secretory neoplasms		*Secretory neoplasms

ClaireLewis at 20:47, 29 September 2019

2019-09-29T20:47:37Z

← Older revision		Revision as of 20:47, 29 September 2019
Line 21:		Line 21:
	*Starvation stools		*Starvation stools
	*Short bowel syndrome		*Short bowel syndrome
	*Cystic fibrosis		*[[Cystic fibrosis]]
	*Celiac disease		*Celiac disease
	*Disaccharidase deficiency		*Disaccharidase deficiency
Line 27:		Line 27:
	*Immunodeficiency		*Immunodeficiency
	*[[Inflammatory bowel disease]]		*[[Inflammatory bowel disease]]
	*Antibiotic-associated diarrhea		*[[Antibiotic]]-associated diarrhea
	*Neonatal drug withdrawal		*[[neonatal abstinence syndrome\|Neonatal drug withdrawal]]
	*[[Toxins]]		*[[Toxins]]
	*[[Hemolytic uremic syndrome]]		*[[Hemolytic uremic syndrome]]
Line 34:		Line 34:
	==Evaluation==		==Evaluation==
	*Clinical diagnosis		*Clinical diagnosis
	*Labs to assess for consequences of GI losses (e.g. BMP, Mg/Phos, VBG) +/- workup to exclude alternative diagnoses		*Labs to assess for consequences of GI losses (e.g. BMP, Mg/Phos, [[VBG]]) +/- workup to exclude alternative diagnoses

	==Management==		==Management==

ClaireLewis: Created page with "==Background== Non-IgE mediated immune reaction to food protein Peak incidence in infants 0-9 months *Cow's milk and soy (in patient's diet or maternal diet if breast fed) a..."

2019-01-27T23:45:24Z

Created page with "==Background== *Non-IgE mediated immune reaction to food protein *Peak incidence in infants 0-9 months *Cow's milk and soy (in patient's diet or maternal diet if breast fed) a..."

New page

==Background==
*Non-IgE mediated immune reaction to food protein
*Peak incidence in infants 0-9 months
*Cow's milk and soy (in patient's diet or maternal diet if breast fed) are most common culprits

==Clinical Features==
*Acute reactions can cause life-threatening volume depletion
**Onset of symptoms ~1-6 hours after ingesting culprit (possibly reintroduced after period of not consuming)
**Profuse, repetitive [[nausea and vomiting (peds)|vomiting]] and voluminous [[diarrhea (peds)|diarrhea]]
**Can lead to profound [[dehydration (peds)|dehydration]], [[shock]], severe [[electrolyte abnormalities]]
**75% of infants with FPIES appear seriously ill, with ~15% requiring hospitalization for hypotension<ref>Nowak-wegrzyn A, Muraro A. Food protein-induced enterocolitis syndrome. Curr Opin Allergy Clin Immunol. 2009;9(4):371-7.</ref>
*Symptoms may be mild-moderate if chronically exposed to offending food
**Chronic watery [[diarrhea (peds)|diarrhea]] with blood or mucus, [[nausea and vomiting (peds)|vomiting]], [[failure to thrive (peds)|failure to thrive]]

==Differential Diagnosis==
{{n/v peds newborn}}

{{n/v peds infant}}

*Overfeeding
*Starvation stools
*Short bowel syndrome
*Cystic fibrosis
*Celiac disease
*Disaccharidase deficiency
*Secretory neoplasms
*Immunodeficiency
*[[Inflammatory bowel disease]]
*Antibiotic-associated diarrhea
*Neonatal drug withdrawal
*[[Toxins]]
*[[Hemolytic uremic syndrome]]

==Evaluation==
*Clinical diagnosis
*Labs to assess for consequences of GI losses (e.g. BMP, Mg/Phos, VBG) +/- workup to exclude alternative diagnoses

==Management==
*Remove offending agent from diet (and maternal diet if patient breastfed)
*Volume resuscitation (see: [[dehydration (peds)]])
*Correct [[electrolyte abnormalities]]
*[[Antiemetics]] prn
*If severe<ref>Current Treatment Options in Allergy. Jarock-Cyrta E, Valverde-Monge M, Nowak-Wegrzyn A. Management of Food Protein-Induced Enterocolitis Syndrome (FPIES): Current Approach and Future Needs. Current Treatment Options in Allergy 2017; 4:383</ref> (e.g. intractable vomiting, ill-appearing, lethargic, hypotensive)
**[[Methylprednisolone]] 1mg/kg IV
**[[Epinephrine]] 0.01 mg/kg IM if shock/hypotension refractory to IV fluids

==Disposition==
*Admit if requires IV rehydration, electrolyte abnormalities, or intractable symptoms

==See Also==

==External Links==

==References==
<references/>

[[Category:Pediatrics]]
[[Category:GI]]

Food protein-induced enterocolitis syndrome - Revision history

Ostermayer: Prepared the page for translation

Mtjordan91: /* Differential Diagnosis */

ClaireLewis at 20:47, 29 September 2019

ClaireLewis: Created page with "==Background== *Non-IgE mediated immune reaction to food protein *Peak incidence in infants 0-9 months *Cow's milk and soy (in patient's diet or maternal diet if breast fed) a..."

ClaireLewis: Created page with "==Background== Non-IgE mediated immune reaction to food protein Peak incidence in infants 0-9 months *Cow's milk and soy (in patient's diet or maternal diet if breast fed) a..."