Food Allergies by Scott H. Sicherer

Author:Scott H. Sicherer
Language: eng
Format: epub
Publisher: The Johns Hopkins University Press
Published: 2013-05-24T16:00:00+00:00

FOOD PROTEIN–INDUCED ENTEROCOLITIS SYNDROME

My infant had severe vomiting two hours after a meal, became pale and sleepy, and later had diarrhea. Is that a food allergy?

It may be a food allergy called food protein–induced enterocolitis syndrome (FPIES).

What is FPIES?

This is a serious food allergy that usually starts in infancy. The symptoms are severe vomiting and diarrhea. Unlike typical food allergies, there are no hives or wheezing, and allergy tests by skin or blood are negative.

How would I know if my infant has FPIES?

There is a typical pattern of symptoms that differ depending on whether the food has been a consistent part of the diet or was ingested after a period of avoidance. FPIES is often initially misdiagnosed as an infection, with consideration of a food allergy coming up when repeated symptoms are noted from reintroduction of the trigger foods.

What are the symptoms of FPIES when a baby is routinely eating the food that causes the reaction?

The infant will have increasing vomiting and diarrhea and may appear pale and lethargic. He or she can seem very ill, and physicians might suspect a serious infection or surgical problem.

What are the symptoms of FPIES from first ingestion of a food or from reintroducing it after not eating it for a time?

The infant or young child appears perfectly well for about one to three hours but then begins to vomit, often profusely and repetitively. The child may become pale or blue in color and lethargic, with low blood pressure. Several hours later there is often diarrhea. The illness looks very much like a severe infection. If a blood test is performed, there may be a large number of cells called neutrophils and a high number of platelets, another blood component. The blood test results may lead a doctor to further suspect infection.

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