All issues > Volume 44(7); 2001

Original Article

J Korean Pediatr Soc. 2001;44(7):758-763. Published online July 15, 2001.

Clinical Features of Food Protein-Induced Enterocolitis Syndrome

Jeong Sik JS Seo¹, Hai Lee HL Chung¹

¹Department of Pediatrics, College of Medicine, The Catholic University of Korea, Taegu, Korea

Abstract

Purpose
: Food protein-induced enterocolitis syndrome(FPIES) is a symptom complex of severe vomiting and diarrhea which is known as a food-related gastrointestinal hypersensitivity disorder without evidence of IgE-mediated sensitivity. We described the clinical characteristics of FPIES in young infants.
Methods
: Twenty-eight patients, aged 7 to 120 days, were included who were diagnosed as FPIES by clinical criteria and food challenges. The clinical and laboratory features on admission and the findings from endoscopic biopsies were investigated. Food challenges with milk and soy were performed.
Results
: Nineteen patients(67%) were admitted with diarrhea, four(15%) with vomiting and five (18%) with both vomiting and diarrhea. Fourteen patients(50%) were ill enough to require evaluation for sepsis but with negative results. Leukocytosis was noticed in twenty(71%), acute phase reactants increased in eighteen(64%), metabolic acidosis was observed in seventeen(61%) and hypoalbuminemia in twelve(43%). Duodenal biopsy specimens showed edema and acute inflammation in all patients. Villus atrophy was found in sixteen patients(57%) with no significant correlation between the degree of villus atrophy and the symptom severity. Diarrhea was elicited in 64% of total food challenges, vomiting and diarrhea in 25%, vomiting only in 7%. Shock state was developed in 25% of challenges.
Conclusion
: Our results suggest that food-related gastrointestinal hypersensitivity can cause a syndrome similar clinically to severe infection and FPIES should be suspected in young infants who have protracted diarrhea with or without vomiting.

Keywords :Food protein-induced enterocolitis, FPIES