Can food protein induced enterocolitis syndrome shift to immediate gastrointestinal hypersensitivity? A report of two cases

SUMMARY

Food protein induced enterocolitis syndrome (FPIES) is a food-related non-IgE-mediated gastrointestinal hypersensitivity disorder. Atypical FPIES is characterized by the presence of specific IgE for the causative food. The guidelines suggested for diagnostic Oral Food Challenge in pediatric patients affected by suspected FPIES are different from the ones for children with IgE-mediated food allergy. We describe two cases of atypical FPIES that turned into IgE-mediated gastrointestinal anaphylaxis. Our experience suggests to adapt OFC according to the outcome of specific IgE for the causative food. When causative foodrelated IgE were positive, we suggest to follow the guidelines for IgE mediated food allergy.