Food Reintroduction in FPIES
DOI:
https://doi.org/10.58931/cait.2021.1116Abstract
The aim of this article is to inform practitioners on a safe and reliable strategy for introduction of the food in the context of FPIES. This approach can be utilised to confirm the diagnosis in a suspected patient or to confirm the persistence of FPIES. A confirmational challenge is recommended to establish a diagnosis and avoid the unnecessary burden of avoiding a food that is not responsible. Ultimately, it is a shared decision between the patient/family and clinician to perform a challenge especially if the original reaction was severe. Unlike IgE-mediated allergies, a challenge in FPIES should never be converted to a therapeutic protocol; oral immunotherapy is not applicable to FPIES. IgE-mediated allergies can be treated with oral immunotherapy (OIT). If a food challenge were to induce a reaction, clinicians might consider switching over to OIT to treat the allergy. FPIES can present with or without symptoms. If a challenge or reintroduction fails in FPIES, clinicians can discontinue and attempt it again later.
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