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Food protein-induced gastrointestinal disease in childhood

Food protein-induced gastrointestinal disease in childhood
Disorder Target IgE-mediated? Symptoms
Immediate hypersensitivity Systemic Yes Rapid onset of nausea, abdominal pain, vomiting, and/or diarrhea; often with hives and wheezing
Oral allergy syndrome Oral Yes Mild tingling or angioedema of the lips or oropharynx; occasional sensation of tightness in the throat
Eosinophilic esophagitis Esophagus No; T cell-mediated Gastroesophageal reflux, dysphagia, abdominal pain, or lack of histologic response to acid suppression; ± esophageal strictures
Eosinophilic gastroenteritis Stomach, small bowel No; T cell-mediated Recurrent abdominal pain, intermittent vomiting, failure to thrive, or weight loss; ± ascites
Food protein-induced allergic proctocolitis Rectum, sigmoid colon No Gross or occult blood in stool; otherwise, typically asymptomatic
Food protein-induced enteropathy Small bowel No Diarrhea or steatorrhea, abdominal distension, failure to thrive, nausea, or vomiting
Food protein-induced enterocolitis syndrome (FPIES) Small bowel, colon No Protracted vomiting and diarrhea (± blood), dehydration, shock, or failure to thrive
IgE: immunoglobulin E.
Courtesy of Alan M Lake, MD.
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