¿La patata es culpable?

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Abstract

Resumen El síndrome de enterocolitis inducida por proteínas alimentarias (FPIES o food protein-induced enterocolytis syndrome) es una patología alérgica no mediada por IgE inducida por proteínas alimentarias. Cursa con vómitos de repetición asociados a diarrea, palidez, letargia o hipotensión 1-4 horas tras la ingesta del alimento desencadenante. Los desencadenantes más habituales son la leche de vaca y la soja; sin embargo, también se han descrito asociada a alimentos sólidos, como la patata.

Translated abstract

Abstract Food protein-induced enterocolitis syndrome (FPIES) is a non IgE mediated allergic disorder induced by food protein that presents in young infants. It is characterized by persistent vomiting associated to diarrhea, lethargy, pallor or hypotension presenting 1-4 hours after the ingestion of the triggering food. The most frequent triggers are cows's milk and soy, but solid foods have also been described as triggers, including potato.

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Food protein-induced enterocolitis syndrome caused by solid food proteins.

Anna Nowak, John H. Sampson, Scott H Sicherer … (2003)

Infantile food protein-induced enterocolitis syndrome (FPIES) is a severe, cell-mediated gastrointestinal food hypersensitivity typically provoked by cow's milk or soy. Solid foods are rarely considered a cause. To describe the clinical characteristics and natural history of FPIES provoked by solid foods. Patients with FPIES induced by solid foods were identified and their clinical course compared with a control group with FPIES caused by cow's milk and/or soy evaluated over the same time period. Fourteen infants with FPIES caused by grains (rice, oat, and barley), vegetables (sweet potato, squash, string beans, peas), or poultry (chicken and turkey) were identified. Symptoms were typical of classical FPIES with delayed (median: 2 hours) onset of vomiting, diarrhea, and lethargy/dehydration. Eleven infants (78%) reacted to >1 food protein, including 7 (50%) that reacted to >1 grain. Nine (64%) of all patients with solid food-FPIES also had cow's milk and/or soy-FPIES. Initial presentation was severe in 79% of the patients, prompting sepsis evaluations (57%) and hospitalization (64%) for dehydration or shock. The diagnosis of FPIES was delayed, after a median of 2 reactions (range: 2-5). Thirty patients with typical cow's milk- and/or soy-FPIES were identified for comparison. Overall, 48% of the 44 infants with FPIES were reactive to >1 food protein, and the risk for multiple food hypersensitivity approached 80% in the infants with solid food or soy-induced FPIES. None of the patients developed FPIES to maternally ingested foods while breastfeeding unless the causal food was fed directly to the infant. Cereals, vegetables, and poultry meats, typically regarded as of low allergenic potential, must be considered in the evaluation of FPIES, particularly in infants previously diagnosed with FPIES to cow's milk or soy, and as an initial cause in patients who have been exclusively breastfed. Infants with FPIES are at risk for multiple dietary protein hypersensitivities during an apparent period of immunologic susceptibility. Pediatricians should consider FPIES in the differential diagnosis of shock and sepsis.

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Expression of transforming growth factor β1, transforming growth factor type I and II receptors, and TNF-α in the mucosa of the small intestine in infants with food protein–induced enterocolitis syndrome

Hai Lee Chung, Jin Hwang, Jeong Park … (2002)

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Natural history of food protein-induced enterocolitis syndrome

Yitzhak Katz, Michael R. Goldberg (2014)

Purpose of review Because of the paucity of reports and variability in the diagnostic criteria utilized, little is known regarding the natural outcome of patients with food protein-induced enterocolitis syndrome (FPIES). Data extracted from referenced manuscripts, as well as allergists’ unpublished observations from across the globe, were used to form a cohesive opinion regarding its natural outcome. Recent findings All authors concur that there is a generally high rate of recovery for FPIES. The most common foods causing FPIES are milk and soy. Depending upon which study is analyzed, by the age of 3–5 years, approximately 90% of patients recover from their disease. Recovery from FPIES to solid foods, occurs at a later age, but may reflect a later stage of introduction of the food into the diet. An important clinical outcome, although not common, is a shift from FPIES food hypersensitivity to an IgE-mediated food allergy. This necessitates a change in the oral food challenge protocol, if IgE-mediated sensitization is detected. Summary Over the past several years, there has been an increasing awareness of FPIES. This knowledge should lead to a more timely diagnosis and should reassure parents and practitioners alike regarding its favorable course.

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Journal ID (publisher-id): pap

Title: Pediatría Atención Primaria

Abbreviated Title: Rev Pediatr Aten Primaria

Publisher: Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )

ISSN (Print): 1139-7632

Publication date (Print and electronic): December 2019

Volume: 21

Issue: 84

Pages: 411-414

Affiliations

[1] Madrid orgnameHospital Universitario Ramón y Cajal orgdiv1Servicio de Pediatría España

[2] Madrid orgnameHospital Universitario 12 de Octubre orgdiv1Servicio de Pediatría orgdiv2Sección de Gastroenterología, Hepatología y Nutrición Infantil España

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Publisher ID: S1139-76322019000400017 Publisher ID: S1139-7632(19)02108400017

SO-VID: 9b2b4a03-183a-4915-aafc-c1f95d857820

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

¿La patata es culpable? Translated title: Is the potato guilty?

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Most cited references 7

Food protein-induced enterocolitis syndrome caused by solid food proteins.

Expression of transforming growth factor β1, transforming growth factor type I and II receptors, and TNF-α in the mucosa of the small intestine in infants with food protein–induced enterocolitis syndrome

Natural history of food protein-induced enterocolitis syndrome

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