All parents of children allergic to any food are meticulous when offering food to their children, especially parents of children who have developed anaphylaxis.
Anaphylaxis is the most serious form of allergy, as it can lead to the death of the person who suffers it. Recently, another potentially very serious clinical picture has been described, but it is not a form of allergy (it is not mediated by immunolgobulin E), but rather a form of intolerance. This disease has a peculiar name: FPIES, is the Food Protein Induced Enterocolitis Syndrome in children.
The term FPIES is an acronym whose translation from English means 'Food Protein Enterocolitis Syndrome'. It is a potentially serious type of food intolerance.
What are the clinical manifestations of FPIES in children?
This disease can manifest itself in two ways:
- Acute or classical form. The symptoms are very dramatic, typically including repeated vomiting, paleness, weakness, lethargy, drop in blood pressure, and risk of dehydration. All these symptoms appear 1-3 hours after ingesting the trigger food.
- Other forms of presentation. In other patients, the presentation is much more progressive, not as abrupt, and includes vomiting, diarrhea, and weight loss.
What are the foods most frequently implicated in this intolerance?
The foods with which it has been most related are cow's milk proteins, and some cereals (soy, wheat, oats), although it can appear with almost any food (chicken, fish, peas, green beans, etc).
How can Food Protein Induced Enterocolitis Syndrome be diagnosed in children?
Its diagnosis is clinical. Allergic tests do not help to detect this problem.
Treatment for FPIES in childhood
FPIES needs management in a hospital center, given its potential severity:
1- Intravenous fluid therapy to avoid dehydration and improve blood pressure.
2- Intravenous corticosteroids.
3- Ondansetron (antiemetic).
This treatment is usually effective, and makes the child recover after several hours of observation. However, the most effective treatment is to prevent its appearance, avoiding the intake of food that is problematic for the child.
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