Syndrome d’entérocolite induit par les protéines alimentaires : nouvelle observation et revue de la littérature

Abstract

We report one case of food protein-induced entererocolitis syndrome (FPIES) with milk whose signs of intolerance to milk began as of the first life days, by minor and nonspecific symptoms. Three foods are in question, cow's milk, soya and corn. The diagnosis of FPIES is suspected at the age of 9 months after three hospitalizations for vomiting out of jet, sometimes associated with lethargy and hypotension, occurring two hours after the cow milk ingestion, This symptomatology is associated with negative results of specific IgE and cutaneous tests. Signs then occurred with soja and wheat. Because of late diagnosis, three anaphylactic shocks occurred. FPIES is an uncommon cell-mediated food allergy reaction. This syndrome is characterized by gastrointestinal symptoms, especially severe vomiting, sometimes associated with anaphylactic shock. Usually, signs occur two hours after ingestion. These reactions begin early in the first months of life and regress at the age of 3 years in 38% to 100% of cases depending on the food. They are usually induced by cow milk and soy proteins. Diagnosis is difficult and delayed because of non-specific symptoms. Oral food challenge is the only examination that confirms the diagnosis. The treatment involves the exclusion of the specific food. Severe reaction requires treatment of the shock and, what is particular in that pathology, the adjunction of corticosteroid.