Management of Acute FPIES Emergencies at Home and in a Medical Facility.

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. Data Sources This review summarizes the clinical context, pathophysiology, presentation, and treatment of FPIES emergencies. We provide recommendations on management of FPIES emergencies in a medical facility versus at home. 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. Better understanding of the pathophysiology of FPIES 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.