Food is essential for growth, nutrition, and good health. Yet at times, food proteins have the potential to be allergens, inducing systemic responses by the body. Allergic reactions to food proteins are typically thought of as IgE-mediated type I hypersensitivity reactions that can cause life-threatening anaphylaxis and require emergency medical treatment. However, food protein–induced enterocolitis syndrome (FPIES) is a non–IgE-mediated allergic reaction to food proteins, primarily in infants, that is much less common, although not rare, with an incidence approaching 0.7%. It has a variable clinical presentation, typically characterized by vomiting and diarrhea associated with allergen ingestion. Presentations range from mild-moderate to severe or even chronic forms. It remains a largely clinical diagnosis.
FPIES is a non–IgE-mediated reaction to food protein. The causative immunologic response implicated in disease formation is activation of the innate immune system. Ingestion of allergens induces activation of monocytes, neutrophils, and eosinophils, which is accompanied by...
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