Recurrent FPIES to wheat after multiple tolerant exposures in a male infant

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated reaction to food that typically presents in infancy and manifests as repetitive vomiting, lethargy and hypotension 1 to 4 hours after ingestion, occasionally followed by delayed diarrhea. Due to lack of a diagnostic biomarker, oral food challenge (OFC) remains the gold standard for diagnosis of FPIES and to monitor for resolution. Supervised introduction of high-risk foods has also been recommended given the high rate of cross-reactivity of some foods.

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