A systematic review of food protein–induced enterocolitis syndrome from the last 40 years

Publication date: April 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 4
Author(s): Sara Manti, Salvatore Leonardi, Annamaria Salpietro, Giuliana Del Campo, Carmelo Salpietro, Caterina Cuppari
ObjectiveTo provide a complete, exhaustive summary of current literature relevant to food protein–induced enterocolitis syndrome (FPIES).Data SourcesData have been extracted from PubMed and Science Direct databases.Study SelectionsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, a literature search for peer-reviewed journal articles in English through January 1975 with updates through October 2016 was conducted. Relevant publications were reviewed that included pediatric and adult populations. Information on the study design, sample, intervention, comparators, outcome, timeframe, and risk of bias were abstracted for each article.ResultsOf 135 reviewed reports, 52 were included in this systematic review. In accordance with the age at onset, clinical features, and offending foods, it is possible to distiguish different types of FPIES. An immune systemic involvement can occur in patients with FPIES. In addition to the most common causative foods (cow's milk, soy, and rice), any food can potentially cause FPIES. Although specific diagnostic tests are not available, open food challenge remains the gold standard for FPIES diagnosis. Moreover, because of the lack of randomized clinical trials and of use of different adopted methods, confounding factors might mask critical findings, leading to poor knowledge of this pleiotropic clinical entity.ConclusionMulticenter studies are needed to better develop an evidence-based approach to pathophysiology, prevalence, diagnosis, and natural history of the disease.



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