FPIES and Non- IgE mediated food allergy

Question 1

Allergic Protocolitis (AP)
Name some features

Answer 1

1. small amount of rectal bleeding in an otherwise healthy infant
2. Disappearance of symptoms after all antigens are removed from diet
3. Exclusion of other cause of rectal bleeding

Question 2

Food protein induced enteropathy (FPE) diagnostic criteria

Answer 2

1. < 9 months of age at initial diagnosis
2. Repeated exposure to causative food elicits GI symptoms without an alternative cause (vomiting and FTT)
3. confirmation of diagnosis by small bowel biospy showing villous injury, crypts hyperplasia and inflammation
4. Removal of causative food results in resolution of symptoms within several weeks, although complete healing of villous injuries takes several months

Question 3

Diagnostic criteria for FPIES

Answer 3

1. < 2 years of age at first presentation
2. Exposure to inciting food elicits repetitive and projectile vomiting, pallor, lethargy within 2-4 hours
3. Absence of symptoms that may suggests an IgE mediated reaction
4. Avoidance of offending protein from the diet results in resolution of symptoms
5. Re- exposure or OFC elicits typical symptoms within 2-4 hours. Two typical episodes are needed to establish to definitive diagnosis without the need to perform an OFC