Clinical case of acute food-protein induced enterocolitis syndrome (FPIES) as a manifestation of multiple food allergies

Abstract

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy manifested by delayed onset of gastrointestinal symptoms (1–4 hours after allergen consumption), which can lead to severe life-threatening conditions. The absence of specific laboratory markers of FPIES allowing to determine the trigger and confirm the diagnosis, unclear clinical features often masked by acute intestinal infections and other gastrointestinal diseases create significant difficulties in identifying patients with FPIES, choosing the right tactics for their management, and prescribing an adequate elimination diet. This article presents a clinical case of a patient who had multiple episodes of severe clinical manifestations of FPIES since the age of 6 months, requiring emergency hospitalization. The diagnosis of FPIES was first suspected at the age of 1.5 years; subsequently, the diagnosis was clinically confirmed, and a plan for further management of the child was developed. Key words: food protein-induced enterocolitis syndrome (FPIES), children, diagnosis, food allergy, trigger, oral food challenge test, cow’s milk protein allergy, meat allergy