Nahrungsmittelprotein-induziertes Enterokolitis-Syndrom

ZUSAMMENFASSUNG

Das Nahrungsmittelprotein-induzierte Enterokolitis-Syndrom (engl.: Food protein-induced enterocolitis syndrome, im Folgenden als FPIES bezeichnet) ist eine nicht-IgE-vermittelte Nahrungsmittelallergie und präsentiert sich in 2 Formen. In einer akuten Form, die vom Säuglings- bis ins Erwachsenenalter vorkommt und einer chronischen Form, die man ausschließlich bei Säuglingen sieht. Die akute Form geht mit verzögert auftretendem und beeindruckend starkem Erbrechen sowie daraus resultierendem raschem gastrointestinalem Flüssigkeitsverlust einher. Die chronische Verlaufsform tritt vor der Beikosteinführung auf und ist durch Erbrechen, Diarrhö und Gedeihstörung gekennzeichnet. Bei langanhaltender Symptomatik kann sich auch das Kind mit chronischem FPIES in einer kritischen Situation befinden, wenn Exsikkose, Elektrolytverschiebung und Azidose auftreten. Die häufigsten Auslöser in Deutschland sind Kuhmilch und Fisch. Die strikte Meidung des auslösenden Nahrungsmittels ist unerlässlich. Der Beratung kommt ein hoher Stellenwert zu. Sie beinhaltet die Punkte Beikosteinführung bei Säuglingen, Notfallmanagement, Prognose und den Zeitpunkt einer Toleranzüberprüfung. Die Erkrankung kann negative Auswirkungen auf die Lebensqualität und die psychosoziale Gesundheit der Patienten und Familien vermindern.

ABSTRACT

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy and presents in two forms. The acute FPIES, which occurs from infancy to adulthood, and a chronic FPIES, which is exclusively seen in infants. The acute FPIES is accompanied by delayed and severe vomiting and the resulting rapid loss of gastrointestinal fluids. The chronic FPIES occurs before the introduction of complementary foods and is characterised by vomiting, diarrhoea and failure to thrive. If the symptoms persist for a long time, the child with chronic FPIES may also be in a critical situation if exsiccosis, electrolyte imbalance and acidosis occur. The most common triggers in Germany are cow’s milk and fish. Strict avoidance of the triggering food is essential. Counselling is of great importance and includes the introduction of complementary foods in infants, emergency management, prognosis and the timing of a tolerance test. It can minimise negative effects on the quality of life and psychosocial health of patients and families.

Schlüsselwörter

Nahrungsmittelprotein-induziertes Enterokolitis-Syndrom - Food protein-induced enterocolitis syndrome - FPIES - nicht-IgE-vermittelte Nahrungsmittelallergie

Keywords

Food protein-induced enterocolitis syndrome - food protein-induced enterocolitis syndrome - FPIES - non-IgE-mediated food allergy

Publikationsverlauf

Artikel online veröffentlicht:
10. Juni 2024

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