| Diagnosisof FPIESis satisfiedif in the presenting episode(s) |
All the underlyng items are met:
-Disappearance of the symptoms of vomiting anddiarrhea, and of diagnostic findings in the stool (blood and leukocytes), after all antigens are removed from diet. -No other cause for the colitis is demonstrable. -Symptoms do not recur and weight gain is normal for one month on a low-antigenformula, such as breast milk or casein hydroly-sate formula, as the only dietary source. -Challenge with milk or soy formula, or other offending food antigens, reproduces symptoms.
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All the underlyng items are met:-Less than 9 months of age at initial presentation [reaction].
-Repeated exposure to the incriminated food elicited diarrhea and/or repetitive vomiting within 24 h without any other cause for the symptoms. -There were no symptoms other than gastrointestinal symptoms elicited by the incriminated food. -Removal of the offending protein fromthe diet resulted in resolution of the symptoms, and/or a standardized food challenge elicited diarrhea and/or vomiting within 24 h after administration of the food.
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All the underlyng items are met:
-Less than 9 months of age at initialdiagnosis. -Repeated exposure to causative food elicits gastrointestinal symptoms without alternative cause. -Absence of symptoms that may suggest an IgE-mediatedreaction. -Removal of causative food results in resolution of symptoms. -Re-exposureor oral food challenge elicits typical symptoms within4 h.
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All the underlyng items are met:
-Less than 2 years of age at first presentation [frequent feature but not mandatory]. -Exposure to the incriminated food elicits repetitive and important vomiting, pallor, hyporeactivity and lethargy within 2-4 h. -Diarrhea may be present, much less frequently and later. The symptoms last a few hours, usually fewer than 6 h. -Absence of symptoms that may suggest an IgE-mediatedreaction. -Avoidance of theoffending proteinfrom the diet results in resolution of symptoms. -Re-exposure ororal food challenge elicits typical symptoms within 2-4 h. Two typical episodes are needed to deliver the definitive diagnosis.
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All the underlyng items are met:
-Major criteria-Repetitive vomiting ordiarrhea within 6 h of food ingestion. -Absence of cutaneous andrespiratory symptoms suggestive of an IgE-mediated allergy. -Removal of causativefood results in resolution of symptoms. -Re-exposure or a food challenge elicits thetypical symptoms.Minor criteria-Hypotension. -Lethargy, pallor, or hypo-tonia. -Negative skin-prick test and undetectable specific IgElevel. -Absence of fever or hypothermia [36°C]
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Major criterion and at least 2 minor criteria are met:
-Major criterion: -repetitive vomiting (0.5-4 hours)after eating a suspect food(s)Minor criteria: -A second (or more) episode ofrepetitive vomiting (0.5-4 hours) after eating the same suspect food-Repetitive vomiting episode (0.5-4 hours) after eatinga different food-Associated flop-piness, pallor, and/ or diarrhea (within 24 hours) during atleast one episode-Need for an emergency roomvisit and/or intravenous fluid therapy during at least one reaction
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Major criterion and at least 3 minor criteria are met:
Major criterion -Vomiting in the 1-4 hour period after ingestion of the suspect food and the absence of classic IgE-mediated allergic skin or respiratory symptoms. Minor criteria-A second [or more] episode ofrepetitive vomitingafter eating the same suspect food. -Repetitive vomiting episode 1-4 h after eating a different food. -Extreme lethargy with any suspectedreaction. -Marked pallor with any suspectedreaction. -Need for emergency room visitwith any suspected reaction. -Need for intravenous fluid support with any suspectedreaction. -Diarrhea in 24 h [usually 5-10 h]. -Hypotension. -Hypothermia.
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