SEIPA syndrome

(FPIES)

Acronym in french for Syndrome d'Enterocolite Induit par les Proteines Alimentaires.

Rare. Especially affects infants. Particular form of food allergy (non-IgE-mediated food hypersensitivity) the signs of which are mainly digestive. Pathophysiology is complex: it is probably a local inflammation  mediated by T cells; however specific IgE for food are found in about 25% of patients

Acute form: vomiting in jet with hypotonia and lethargy starting 1 to 3 hour after ingestion of the causal food; sometimes viscous or bloody diarrhea 6 to 12 hours later. Severe forms can lead to hypovolemic shock.

Insidious form: agitation, gastroesophageal reflux, stools; finally, growth retardation. The diagnosis is often delayed.

Foods most often in question: milk (median of 1st reaction time: 20 days) soy protein, rice; more rarely: fish, chicken, oats. The signs appear between 1 and 4 weeks after the introduction of the food.

Treatment: plan food exclusion during at least 1 year followed an attempt to reintroduce the causal food.

Diagnosis: test of exclusion-reintroduction of the suspect food (milk, soy)

With regard to milk and soy, spontaneously disappears between the age of 3 and 5 years.


Anesthetic implications:

atopy; hypovolemia if recent vomiting and diarrhea; anemia, hypoproteinemia; growth retardation.


References : 

-        Leonard SA, Nowak-Wegrzyn A. 
Food protein-induced enterocolitis syndrome : an update on natural history and review of management. 
Ann Allergy Asthma Immunol 2011; 107: 95-101.

-        Delahaye C, Chauveau A, Kiefer S, Dumond P.
Syndrome dentérocolite induite par les protéines alimentaires (SEIPA) : une série de 14 enfants.
Arch Pédiatr 2017 ; 24 : 310-6.


Updated: April 2017