Acute food protein-induced enterocolitis syndrome (FPIES) is characterized by delayed repetitive vomiting after ingestion of a trigger food, and severe reactions may lead to dehydration, hypotension and shock.

A new study published in Annals of Allergy, Asthma & Immunology aimed to summarize the clinical context, pathophysiology, presentation and treatment of FPIES emergencies.

This study provided recommendations on management of FPIES emergencies in a medical facility versus at home. Here, a literature search was performed identifying relevant recent primary articles and review articles on clinical management while referring to the 2017 International Consensus Guidelines for the Diagnosis and Management of FPIES.

The findings indicated that management of FPIES emergencies in a medical facility is based on severity of symptoms and involves rehydration, ondansetron and corticosteroids. A proactive approach for reactions occurring at home comprises prescribing oral ondansetron and constituting an individualized treatment plan based on the evolution of symptoms and severity of past reactions. In addition, better understanding of the pathophysiology of FPIES is necessary for more targeted treatments.

It was concluded that children with FPIES are at risk for severe symptoms leading to a medical emergency. Meanwhile, management of FPIES emergencies primarily involves supportive care, with treatment tailored to the symptoms, severity of the patients condition, location of reaction and reaction history.

Source: Annals of Allergy, Asthma & Immunology. 2021 Jan 22;S1081-1206(21)00055-7. doi: 10.1016/j.anai.2021.01.020.