Management of acute food protein-induced enterocolitis syndrome emergencies at home and in a medical facility

Stephanie A. Leonard, Stefano Miceli Sopo, Mary Grace Baker, Alessandro Fiocchi, Robert A. Wood, Anna Nowak-Węgrzyn

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Objective: Acute food protein-induced enterocolitis syndrome (FPIES) is characterized by delayed repetitive vomiting after ingestion of a trigger food, and severe reactions may lead to dehydration, hypotension, and shock. We provide recommendations on management of FPIES emergencies in a medical facility and at home. Data Sources: This review summarizes the literature on clinical context, pathophysiology, presentation, and treatment of FPIES emergencies. Study Selections: We referred to the 2017 International Consensus Guidelines for the Diagnosis and Management of FPIES and performed a literature search identifying relevant recent primary articles and review articles on clinical management. Results: Management of FPIES emergencies in a medical facility is based on severity of symptoms and involves rehydration, ondansetron, and corticosteroids. A proactive approach for reactions occurring at home involves prescribing oral ondansetron and providing an individualized treatment plan based on the evolution of symptoms and severity of past reactions. A better understanding of the pathophysiology of FPIES and randomized trials on ondansedron and cocorticosteroid use could lead to more targeted treatments. Conclusion: Children with FPIES are at risk for severe symptoms constituting a medical emergency. Management of FPIES emergencies is largely supportive, with treatment tailored to the symptoms, severity of the patient's condition, location of reaction, and reaction history.

Original languageEnglish (US)
Pages (from-to)482-488.e1
JournalAnnals of Allergy, Asthma and Immunology
Issue number5
StatePublished - May 2021

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine


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