title: Rice protein-induced enterocolitis syndrome.
abstract: 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.
authors.affiliation: Referral Center for Pediatric Gastroenterology and Nutrition, Zagreb Children's Hospital, Klaićeva 16, HR-10000 Zagreb, Croatia. ivahojsak@gmail.com
authors.forename: Iva
authors.initials: I
authors.lastname: Hojsak
authors.forename: Mirjana
authors.initials: M
authors.lastname: Kljaić-Turkalj
authors.forename: Zrinjka
authors.initials: Z
authors.lastname: Misak
authors.forename: Sanja
authors.initials: S
authors.lastname: Kolacek
mesh_terms: 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
chemical_list: D000485:Allergens; D010940:Plant Proteins; D007073:Immunoglobulin E