SciELO - Scientific Electronic Library Online

 
vol.90 issue6Case studies of patients with connatal symptomatic cytomegalovirus infection at the Pereira Rossell Children Hospital author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Related links

Share


Archivos de Pediatría del Uruguay

Print version ISSN 0004-0584On-line version ISSN 1688-1249

Abstract

CURUTCHAGUE, Sofía; CASURIAGA, Ana; GIACHETTO, Gustavo  and  GUISANDE, Andreína. Food protein-induced enterocolitis syndrome (FPIES). A pediatric clinical case. Arch. Pediatr. Urug. [online]. 2019, vol.90, n.6, pp.335-340.  Epub Dec 01, 2019. ISSN 0004-0584.  https://doi.org/10.31134/ap.90.6.6.

Introduction:

the Food Protein- Induced Enterocolitis Syndrome (FPIES) is a rare type of food allergy, not mediated by immunoglobulins E. It mainly affects children below one year of age. Its diagnosis is clinical and treatment are based on the exclusion of the food that triggers it. The objective of this report is to warn about a rare pathology that requires awareness and suspicion in order to set a proper diagnosis and approach.

Clinical case:

5 month-old girl, with a history of atopic dermatitis, exclusively breastfed, who, after the first introduction of a cow milk byproduct, presented vomit, lethargy, hyporeaction, and manifestations of peripheral circulatory failure, like cool distal extremities and delayed capillary refill. No fever. Heart rate 145. No further alterations. Denies ingestion or contact with drugs and/or toxic substances.

We administered a rapid fluid bolus with sodium chloride and oxygen therapy and she improved rapidly. She stayed under observation in an intensive care unit for 24 hours and showed good evolution. The patient was discharged with a diagnosis of paroxysmal episode of unknown etiology. During the evolution, 10 days after the intake of other foods, she experienced an episode of similar characteristics. We consulted with a gastroenterologist, and diagnosed FPIES, and she was prescribed an exclusion diet.

Conclusions:

considering the similarity of FPIES clinical manifestations with those of other more prevalent diseases, it is important that pediatricians know about this condition and are able to suspect about it in order to devise a suitable approach, mainly to avoid future exposure to the food triggering the syndrome.

Keywords : Enterocolitis; Food hypersensitivity; Dietary proteins.

        · abstract in Spanish | Portuguese     · text in Spanish     · Spanish ( pdf )