Diagnostic criteria for food protein–induced enterocolitis syndrome: Can we do better?

Abstract

Acute food protein–induced enterocolitis syndrome (FPIES) is a non–immunoglobulin E (IgE)–mediated food allergy characterized by profuse vomiting usually 1 to 4 hours after ingestion. It is often associated with pallor, lethargy, and diarrhea, and can lead to hypotension and shock. It affects mainly infants when foods are introduced. There are no pathognomonic features or diagnostic biomarkers, partly because the pathophysiology of FPIES is poorly understood. Diagnosis is based on the clinical history and it can be challenging, particularly for nonspecialists.