FPIES

Back in the 1980s we had endless spats with the reactionary dinosaurs in the American College of Allergy, Asthma & Immunology. They couldn’t grasp that “food allergy” could cause all kinds of complex symptoms and reactions, not least in the intestines. It’s just so OBVIOUS it makes you cringe at this ignorance (to the patients’ disadvantage, of course). There were no antibodies, they said, therefore the whole concept was an illusion or fraud. People could not react to food in this way. The whole idea was called “Mumby-Jumbo” in my home city. Actually, I’m quite proud of that! Now, some 30 years later, they have FINALLY woken up to the fact that this happens. Actually, it happens a LOT and they haven’t got that far yet. But at least they have changed their tune. I just saw a study published that’s about what they call food protein-induced enterocolitis syndrome (FPIES). I think food allergy or food intolerance is far simpler! A case was presented at the American College of Allergy, Asthma & Immunology 2012 Annual Scientific Meeting. Progress! FPIES and its triggers (most commonly cow’s milk, rice, and soy) can be difficult to diagnose, lead researcher Tara Federly, MD, a fellow at the Children’s Mercy Hospital and the University of Missouri in Kansas City, told Medscape Medical News. FPIES is not mediated by immunoglobulin (Ig)E, “so it’s not the immediate hypersensitivity reaction that you see with peanut or milk or other allergy,” Dr. Federly explained. “The exact mechanism is not known, but it’s basically an inflammation of the GI tract that is triggered by certain foods. The interesting thing is that it happens hours after ingestion, instead of being a more immediate IgE-mediated reaction,” she said. Well, we told them that; but they wouldn’t listen! It was antibodies or nothing; no antibodies: patients was deluded and sent to a psychiatrist.

Back in the 1980s we had endless spats with the reactionary dinosaurs in the American College of Allergy, Asthma & Immunology. They couldn’t grasp that “food allergy” could cause all kinds of complex symptoms and reactions, not least in the intestines. It’s just so OBVIOUS it makes you cringe at this ignorance (to the patients’ disadvantage, of course). There were no antibodies, they said, therefore the whole concept was an illusion or fraud. People could not react to food in this way. The whole idea was called “Mumby-Jumbo” in my home city. Actually, I’m quite proud of that! Now, some 30 years later, they have FINALLY woken up to the fact that this happens. Actually, it happens a LOT and they haven’t got that far yet. But at least they have changed their tune. I just saw a study published that’s about what they call food protein-induced enterocolitis syndrome (FPIES). I think food allergy or food intolerance is far simpler! A case was presented at the American College of Allergy, Asthma & Immunology 2012 Annual Scientific Meeting. Progress! FPIES and its triggers (most commonly cow’s milk, rice, and soy) can be difficult to diagnose, lead researcher Tara Federly, MD, a fellow at the Children’s Mercy Hospital and the University of Missouri in Kansas City, told Medscape Medical News. FPIES is not mediated by immunoglobulin (Ig)E, “so it’s not the immediate hypersensitivity reaction that you see with peanut or milk or other allergy,” Dr. Federly explained. “The exact mechanism is not known, but it’s basically an inflammation of the GI tract that is triggered by certain foods. The interesting thing is that it happens hours after ingestion, instead of being a more immediate IgE-mediated reaction,” she said. Well, we told them that; but they wouldn’t listen! It was antibodies or nothing; no antibodies: patients was deluded and sent to a psychiatrist.