Authors
Virginie Jubin, Pascale Dumond, Grégoire Benoist, Flore Amat, Harriet Corvol, Laure Couderc-Kohen, Antoine Deschildre, Angélique Doc, Amandine Divaret-Chauveau, Kamal El Abd, Agnès Linglart, Carine Metz-Favre, Anne Hoppe, Karine Levieux, Martine Morisset, Frederic Valla, Sibylle Blanc, Anaïs Lemoine, French Working Group Comprising the SFA (French Allergy Society), and the GFRUP (French‐speaking Pediatric Resuscitation and Emergency Group) and the Sp2A (French Society of Pediatric Pneumology and Allergology) of the SFP (French Pediatric Society)
Published in
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. Volume 37. Issue 7. Pages e70402.
Abstract
Food Protein-Induced Enterocolitis Syndrome (FPIES) is a non-IgE-mediated food allergy marked by delayed vomiting and potential hypovolemic shock. This review by the French FPIES working group (SFA, GFRUP, Sp2A, SFP) analyzes recent literature on oral food challenges (OFC) adverse reactions and proposes a standardized protocol for OFC and emergency management. Early consensus OFC protocols from 2017 showed limitations-mainly short intervals between doses during OFC and high hospitalization burdens-leading to inconsistent practices. This narrative review of 2017-2025 studies shows that a single 25% age-appropriate portion generally suffices to trigger symptoms, typically within 1-4 h. This approach balances safety and feasibility while reducing hospital time. As part of the French FPIES monitoring register, and to easily apply this portion, the serving size for each food has been established with specialized dieticians. According to severity, acute reactions require prompt rehydration and ondansetron. Oral or sublingual ondansetron, effective for mild to moderate reactions, can limit dehydration and hospital transfers. In a hospital setting, oral rehydration is indicated in mild reactions, whereas vascular hydration (10 mL/kg over 5-20 min) is required for moderate to severe reactions. Corticosteroids may be added in severe cases. Adrenaline is unnecessary unless associated IgE-mediated symptoms are observed. The working group also proposes including oral rehydration solution and ondansetron in every home emergency kit. These proposals provide a national consensus on the management of FPIES by standardizing French practice from the OFC to the acute management of allergic reaction both in hospitals and at home.
PMID:
42473072
Bibliographic data and abstract were imported from PubMed on 20 Jul 2026.
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