An unusual case of food protein-induced enterocolitis syndrome due to zucchini

Main Article Content

Alberto García de la Fuente
Victoria Fuentes-Aparicio
Sonsoles Infante

Keywords

Food protein-induced enterocolitis syndrome, FPIES, Gastrointestinal food allergy, Non-IgE-mediated food allergy, Zucchini

Abstract

Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by gastrointestinal symptoms, mainly protracted and delayed vomiting. Diagnosis is based on clinical history, and it can be challenging as symptoms are delayed and the causative food is often not very suspicious.


Objective: This case report highlights the importance of having a high degree of suspicion to reach a correct diagnosis.


Materials and methods: We report an unusual case of FPIES due to zucchini. During the follow-up. Two oral food challenges (OFC) were carried out to evaluate tolerance to the food involved.


Results: The first OFC was positive and in the second the child tolerated the food without problems.


Conclusions: In this case, the OFC was essential to identify the offending food and to verify that the child had overcome the disease.

Abstract 108 | PDF Downloads 58 HTML Downloads 6 XML Downloads 11

References

1. Feuille E, Nowak-Wegrzyn A. Medical algorithms: Recognizing and treating food protein-induced enterocolitis syndrome. Allergy. 2019;74:2019–22. 10.1111/all.13857

2. ADDIN Mendeley Bibliography CSL_BIBLIOGRAPHY Agyemang A, Nowak-Wegrzyn A. Food protein-induced enterocolitis syndrome: A comprehensive review. Clin Rev Allergy Immunol. 2019;57:261–71. 10.1007/s12016-018-8722-z

3. Mehr S, Frith K, Barnes EH, Campbell D. Food protein-induced enterocolitis syndrome in Australia: A population-based study, 2012–2014. J Allergy Clin Immunol. 2017;140:1323–30. 10.1016/j.jaci.2017.03.027

4. Vila L, García V, Rial MJ, Novoa E, Cacharron T. Fish is a major trigger of solid food protein-induced enterocolitis syndrome in Spanish children. J Allergy Clin Immunol Pract. 2015;3:621–3. 10.1016/j.jaip.2015.03.006

5. Vázquez-Ortiz M, Machinena A, Dominguez O, Alvaro M, Calvo-Campoverde K, Giner MT, et al. Food protein-induced enterocolitis syndrome to fish and egg usually resolves by age 5 years in Spanish children. J Allergy Clin Immmunol Pract. 2017;5:521–15.e.1. 10.1016/j.jaip.2016.12.029

6. Ludman S, Harmon M, Whiting D, du Toit G. Clinical presentation and referral characterisitics of food protein-induced enterocolitis syndrome in the United Kingdom. Ann Allergy Asthma Immunol. 2014;113:290–4. 10.1016/j.anai.2014.06.020

7. Nowak-Wegrzyn A, Chehade M, Groetch ME, Spergel JM, Wood RA, Allen K, et al. International consensus guidelines for the diagnosis and management of food protein-induced enterocolitis syndrome: Executive summary—Workgroup report of the adverse reactions to Foods Committee, American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol. 2017;139:1111–26.e4.

8. Ovadia A, Nahum A, Tasher D, Abiri S, Epov L, Kessel A, et al. Sesame: An unrecognized trigger of food protein-induced enterocolitis syndrome. J allergy Clin Immunol Pract. 2019;7:305–6. 10.1016/j.jaip.2018.05.007

9. Lee E, Barnes EH, Mehr S, Campbell DE. Differentiating acute food protein–induced enterocolitis syndrome from its mimics: A comparison of clinical features and routine laboratory biomarkers. J Allergy Clin Immunol Pract. 2019;7:471–8.e3. 10.1016/j.jaip.2018.10.020

10. Kimura M, Ito Y, Shimomura M, Morishita H, Meguro T, Adachi Y, et al. Cytokine profile after oral food challenge in infants with food protein-induced enterocolitis syndrome. Allergol Int. 2017;66:452–7. 10.1016/j.alit.2016.12.001; 10.1016/j.alit.2016.08.003