{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:15:32Z","timestamp":1790151332323,"version":"4.0.1"},"reference-count":49,"publisher":"Oceanside Publications Inc.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Food Allergy"],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Food protein\u2010induced enterocolitis syndrome (FPIES) is a non\u2010immunoglobulin E (IgE) cell mediated food allergy that can cause severe symptoms and is considered an allergic emergency.  <jats:bold>Objective:<\/jats:bold> To describe FPIES epidemiology and\n appraise the approach to diagnosis and management.  <jats:bold>Methods:<\/jats:bold> A review of the relevant articles published in the peer-reviewed journals since the publication of the First International FPIES Consensus Guidelines in 2017.  <jats:bold>Results:<\/jats:bold> FPIES is estimated to\n affect 0.51\u20100.9% of children and 0.22% of adults in the United States. It typically presents with protracted, projectile vomiting, which occurs within 1\u20104 hours of ingesting culprit foods, sometimes followed by diarrhea within 24 hours of ingestion. In \u223c15\u201020% of severe\n cases, patients go into hypovolemic or distributive shock. In chronic FPIES, infants may have failure to thrive and weight loss. The most common triggers include cow\u2019s milk, oat, rice, and avocado, with egg and peanut being more frequently reported. Examples of other common fruit and\n vegetable triggers include banana, apple, and sweet potato. FPIES can be classified into acute, chronic, adult-onset, or atypical subtypes. FPIES is associated with comorbid atopic conditions of IgE-mediated food allergy, atopic dermatitis, asthma, allergic rhinitis, and eosinophilic esophagitis.\n The natural history of infantile FPIES is generally favorable, with the exception of fish FPIES. Seafood FPIES in adults has low rates of resolution over 3\u20105 years. Correctly identifying FPIES can be challenging because there are no specific biomarkers for diagnosis and the constellation\n of symptoms may mimic those of infectious enteritis or sepsis. Management relies on dietary food avoidance, periodic re-evaluations for tolerance with oral food challenges, and management of acute reactions with rehydration and antiemetic ondansetron. Although the pathophysiology of FPIES\n remains poorly understood, underlying mechanisms such as cytokine release, leukocyte activation, and impaired gastrointestinal mucosal barrier function may act as cornerstones for further research.  <jats:bold>Conclusion:<\/jats:bold> Prevention, laboratory diagnostic testing, and strategies to\n accelerate tolerance development are urgent unmet needs in FPIES.<\/jats:p>","DOI":"10.2500\/jfa.2023.5.230014","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T04:43:03Z","timestamp":1703047383000},"page":"55-64","source":"Crossref","is-referenced-by-count":13,"title":["Food protein-induced enterocolitis syndrome (FPIES): Beyond the guidelines"],"prefix":"10.2500","volume":"5","author":[{"given":"Sohini","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Hassenfield Children\u2019s Hospital, Children\u2019s Hospital at Montefiore\/Montefiore Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Grohman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hassenfield Children\u2019s Hospital, Children\u2019s Hospital at Montefiore\/Montefiore Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Nowak-Wegrzyn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, NYU Grossman School of Medicine, New York, New York, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1355","reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/j.jaci.2016.12.966","article-title":"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","volume":"139","author":"Nowak-W\u0119grzyn","year":"2017","journal-title":"J Allergy Clin Immunol"},{"key":"B2","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1016\/j.jaci.2019.06.032","article-title":"Food protein-induced enterocolitis syndrome in the US population-based study","volume":"144","author":"Nowak-Wegrzyn","year":"2019","journal-title":"J Allergy Clin Immunol"},{"key":"B3","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1111\/all.15644","article-title":"Early infancy dysbiosis in food protein-induced enterocolitis syndrome: a prospective cohort study","volume":"78","author":"Su","year":"2023","journal-title":"Allergy"},{"key":"B4","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.anai.2021.01.001","article-title":"The evolution of food protein-induced enterocolitis syndrome: from a diagnosis that did not exist to a condition in need of answers","volume":"126","author":"Bartnikas","year":"2021","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B5","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.jaip.2019.08.020","article-title":"Food protein-induced enterocolitis syndrome","volume":"8","author":"Nowak-Wegrzyn","year":"2020","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B6","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.anai.2016.03.004","article-title":"Chronic food protein-induced enterocolitis syndrome: characterization of clinical phenotype and literature review","volume":"117","author":"Weinberger","year":"2016","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B7","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1016\/j.jaci.2016.12.971","article-title":"Systemic innate immune activation in food protein-induced enterocolitis syndrome","volume":"139","author":"Goswami","year":"2017","journal-title":"J Allergy Clin Immunol"},{"key":"B8","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.jaci.2021.04.012","article-title":"Acute FPIES reactions are associated with an IL-17 inflammatory signature","volume":"148","author":"Berin","year":"2021","journal-title":"J Allergy Clin Immunol"},{"key":"B9","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.jaci.2022.09.035","article-title":"Untargeted serum metabolomic analysis reveals a role for purinergic signaling in FPIES","volume":"151","author":"Lozano-Ojalvo","year":"2023","journal-title":"J Allergy Clin Immunol"},{"key":"B10","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/S0022-3476(78)80887-7","article-title":"Milk- and soy-induced enterocolitis of infancy. 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