title: A systematic review of food protein-induced enterocolitis syndrome from the last 40 years.
abstract: To provide a complete, exhaustive summary of current literature relevant to food protein-induced enterocolitis syndrome (FPIES).
  
  
  
  Data have been extracted from PubMed and Science Direct databases.
  
  
  
  Following 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.
  
  
  
  Of 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.
  
  
  
  Multicenter studies are needed to better develop an evidence-based approach to pathophysiology, prevalence, diagnosis, and natural history of the disease.
authors.affiliation: Department of Pediatrics, Unit of Pediatric Genetics and Immunology, University of Messina, Messina, Italy. Electronic address: saramanti@hotmail.it.
authors.forename: Sara
authors.initials: S
authors.lastname: Manti
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Leonardi
authors.affiliation: Department of Pediatrics, Unit of Pediatric Genetics and Immunology, University of Messina, Messina, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Salpietro
authors.affiliation: Department of Pediatrics, Unit of Pediatric Genetics and Immunology, University of Messina, Messina, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Del Campo
authors.affiliation: Department of Pediatrics, Unit of Pediatric Genetics and Immunology, University of Messina, Messina, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Salpietro
authors.affiliation: Department of Pediatrics, Unit of Pediatric Genetics and Immunology, University of Messina, Messina, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Cuppari
mesh_terms: D000485:Allergens / Q000276:immunology*; D000818:Animals; D004044:Dietary Proteins / Q000145:classification / Q000276:immunology*; D004760:Enterocolitis / Q000175:diagnosis / Q000209:etiology* / Q000266:history; D005512:Food Hypersensitivity / Q000150:complications* / Q000175:diagnosis / Q000266:history / Q000276:immunology*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007111:Immunity, Cellular; D056724:Immunity, Humoral; D010641:Phenotype; D013577:Syndrome
chemical_list: D000485:Allergens; D004044:Dietary Proteins