Jaffe Food Allergy Institute, Division of Pediatric Allergy and Immunology, Mount Sinai School of Medicine, New York, New York 10029-6574, USA.
Ann Allergy Asthma Immunol. 2011 Aug;107(2):95-101; quiz 101, 162. doi: 10.1016/j.anai.2011.06.004.
To review the clinical features, pathophysiology, and management of food protein-induced enterocolitis syndrome (FPIES) and to discuss new observations in epidemiology and natural history.
PubMed searches were performed for articles published between 1978 and May 2011 using the keywords food-induced enterocolitis and FPIES.
Articles were selected based on their relevance to the topic of this review. The newest developments in FPIES were defined by articles published in the past 3 years.
FPIES is a non-IgE-mediated gastrointestinal food hypersensitivity thought to be cell-mediated, although the exact pathophysiologic mechanism requires further study. In a recent birth cohort, the incidence of cow's milk FPIES was 0.34% in the first year of life compared with 0.5% for IgE-mediated cow's milk allergy. FPIES typically presents before 6 months of age in formula-fed infants with repetitive emesis, diarrhea, dehydration, and lethargy 1 to 5 hours after ingesting the offending food. Four cases of FPIES in breastfed infants have recently been reported. The most common offending foods are cow's milk, soy, and rice. Diagnosis is based primarily on clinical history and, when unclear, physician-supervised oral food challenges. FPIES is usually outgrown by school age. Although management remains avoidance of the offending food, observations that natural history varies for different foods has redefined the timing of reintroduction.
Early recognition of FPIES and removal of the offending food are imperative to prevent misdiagnosis and mismanagement of symptoms that may mimic other causes. Close follow-up is required to determine when foods may be added back into the diet.
综述食物蛋白诱导的小肠结肠炎综合征（FPIES）的临床特征、病理生理学和治疗方法，并讨论在流行病学和自然病史方面的新发现。
使用“food-induced enterocolitis”和“FPIES”作为关键词，在 PubMed 上检索 1978 年至 2011 年 5 月期间发表的文章。
根据与本文主题的相关性选择文章。将最近 3 年内发表的文章中 FPIES 的最新进展定义为新发现。
FPIES 是一种非 IgE 介导的胃肠道食物过敏反应，被认为是细胞介导的，尽管确切的病理生理机制仍需进一步研究。在最近的一项出生队列研究中，1 岁以内婴儿的牛奶 FPIES 发病率为 0.34%，而 IgE 介导的牛奶过敏发病率为 0.5%。FPIES 通常在配方喂养婴儿中发病，在摄入致敏食物后 1 至 5 小时出现反复呕吐、腹泻、脱水和嗜睡，发病年龄小于 6 个月。最近报道了 4 例母乳喂养婴儿的 FPIES 病例。最常见的致敏食物是牛奶、大豆和大米。诊断主要基于临床病史，对于不明确的病例，可进行医生监督下的口服食物激发试验。FPIES 通常在上学年龄时自行缓解。尽管治疗方法仍然是避免食用致敏食物，但不同食物的自然病史变化重新定义了重新引入食物的时间。
早期识别 FPIES 并去除致敏食物对于避免误诊和错误处理可能类似其他病因的症状至关重要。需要密切随访以确定何时可以将食物重新添加到饮食中。
