Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated reaction to food well-known in the allergy and immunology literature that presents with delayed gastrointestinal symptoms. It is classically diagnosed in children and infants, however new-onset cases have recently been identified in the adult population. Summary: There is a paucity of literature on FPIES in the gastroenterology literature. This review aims to bring awareness to this entity as a possible etiology of gastrointestinal symptoms. Symptoms include abdominal pain, diarrhea, repetitive vomiting, and nausea, which occur one to four hours after initial ingestion of food. In adult-onset cases, food triggers most often include seafood (fish, crustacean, and mollusk). Egg, wheat, and cow’s milk have also been identified as triggers for adult-onset FPIES. Oral food challenge (OFC) is the gold standard for diagnosis. Key Messages: This review provides an overview of the current literature on adult-onset FPIES. Adult and pediatric patients notably have different presentations of FPIES and different triggers. Providers should be aware of these distinctions when diagnosing this condition.
Ahmed et al. (Fri,) studied this question.