title: Food protein-induced enterocolitis syndrome to trivial oral mucosal contact.
abstract: Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E (IgE)-mediated gastrointestinal food hypersensitivity, mostly in infants. Patients usually present very ill and often misdiagnosed as acute gastroenteritis, sepsis, ileus, metabolic disorders, necrotizing enterocolitis, or severe gastroesophageal reflux disease. We present a case of an infant who had three acute FPIES episodes: the first was at 5 months of age after chewing on a cellophane wrapper, the second was due to sweet potato, and the third was due to rice cereal. It was realized that in the first episode, the wrapper was covering a rice cake. Evaluation at 7 months of age, while asymptomatic, showed normal complete blood count, low serum immunoglobulin E level, and negative allergy skin prick tests, indicating non-IgE sensitivity. Conclusion This case of FPIES has peculiar features in that it occurred in an exclusively breastfed infant and by non-ingestant oral contact with a trivial quantity of rice allergen.
authors.affiliation: Allergy and Immunology Section, Department of Pediatrics, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA, 71130, USA.
authors.forename: Shikha K
authors.initials: SK
authors.lastname: Mane
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Hollister
authors.forename: Sami L
authors.initials: SL
authors.lastname: Bahna
mesh_terms: D001942:Breast Feeding; D004044:Dietary Proteins / Q000009:adverse effects*; D004760:Enterocolitis / Q000175:diagnosis / Q000209:etiology*; D005512:Food Hypersensitivity / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D027723:Ipomoea batatas / Q000009:adverse effects*; D008297:Male; D009061:Mouth Mucosa; D012275:Oryza / Q000009:adverse effects*; D013577:Syndrome
chemical_list: D004044:Dietary Proteins