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食物蛋白诱导的小肠结肠炎综合征:新指南综述

Food protein-induced enterocolitis syndrome: a review of the new guidelines.

作者信息

Leonard Stephanie A, Pecora Valentina, Fiocchi Alessandro Giovanni, Nowak-Wegrzyn Anna

机构信息

1Division of Pediatric Allergy & Immunology, University of California, San Diego, Rady Children's Hospital San Diego, 3020 Children's Way, MC 5114, San Diego, CA 92123 USA.

2Division of Allergy, Pediatric Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00126 Rome, Italy.

出版信息

World Allergy Organ J. 2018 Feb 7;11(1):4. doi: 10.1186/s40413-017-0182-z. eCollection 2018.

Abstract

Food protein-induced enterocolitis syndrome (FPIES) is a non IgE-mediated gastrointestinal food allergy that presents with delayed vomiting after ingestion primarily in infants. While the pathophysiology of FPIES is poorly understood, the clinical presentation of acute FPEIS reactions has been well characterized. The first were published in 2017 and reviewed epidemiology, clinical presentation, and prognosis of acute and chronic FPIES. The workgroup outlined clinical phenotypes, proposed diagnostic criteria, and made recommendations on management. This article summarizes the guidelines and adds recent updates. FPIES is gaining recognition, however there continues to be delays in diagnosis and misdiagnosis due to overlap of symptoms with over conditions, lack of a diagnostic test, and because some of the common trigger foods are not thought of as allergenic. More research into disease mechanisms and factors influencing differences between populations is needed.

摘要

食物蛋白诱导的小肠结肠炎综合征(FPIES)是一种非IgE介导的胃肠道食物过敏,主要发生于婴儿,表现为摄入食物后延迟出现呕吐。虽然FPIES的病理生理学尚不清楚,但急性FPEIS反应的临床表现已得到充分描述。首批相关研究发表于2017年,回顾了急性和慢性FPIES的流行病学、临床表现及预后。该工作组概述了临床表型,提出了诊断标准,并就管理提出了建议。本文总结了这些指南并增加了最新进展。FPIES正逐渐得到认可,但由于症状与其他疾病重叠、缺乏诊断测试,以及一些常见的触发食物未被视为过敏原,诊断仍存在延迟和误诊情况。需要对疾病机制以及影响人群差异的因素进行更多研究。

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