Rice protein-induced enterocolitis syndrome.
OBJECTIVE
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated allergic reaction, usually to cow's milk or soy protein. The aim is to present a series of infants with enterocolitis syndrome developed after rice ingestion. To our knowledge, the issue has only once been described in patients from Europe.


METHODS
Data on five patients were retrospectively analyzed. The patients presented with vomiting, diarrhea and dehydration; therefore, allergy was not considered as a diagnosis and the patients underwent broad diagnostic evaluation. Finally, an open food challenge was performed for suspicion of rice allergy.


RESULTS
Detailed clinical and laboratory findings are presented. As all patients had symptoms which could have been indicative of a broad spectrum of diseases, a median of two hospitalizations was needed to establish the diagnosis. When the rice protein-induced enterocolitis syndrome is suspected all patients should undergo open food challenge test, as no other diagnostic procedure can confirm the diagnosis.


CONCLUSIONS
This report shows that even hypoallergenic foods such as rice may cause FPIES and should be considered in the differential diagnosis of profuse vomiting and prostration in infants introduced to some kind of rice protein.
Hojsak
Iva
I
Referral Center for Pediatric Gastroenterology and Nutrition, Zagreb Children's Hospital, Klaićeva 16, HR-10000 Zagreb, Croatia. ivahojsak@gmail.com
Kljaić-Turkalj
Mirjana
M
Misak
Zrinjka
Z
Kolacek
Sanja
S
D000485:Allergens / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D003681:Dehydration; D003937:Diagnosis, Differential; D003967:Diarrhea; D004760:Enterocolitis / Q000175:diagnosis / Q000178:diet therapy / Q000276:immunology*; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D012275:Oryza / Q000737:chemistry*; D010940:Plant Proteins / Q000276:immunology*; D012882:Skin Tests; D014839:Vomiting
D000485:Allergens; D010940:Plant Proteins; D007073:Immunoglobulin E