The aim of this analysis Is to illustrate recent developments in the diagnosis and treatment of non-IgE-mediated food allergy, which is a general concern in primary care, allergy and gastroenterology subspecialty treatments, and paediatric procedures. The study focuses on food protein-induced enterocolitis syndrome (FPIES), but it also discusses other non-IgE-mediated food allergies in breastfeeding babies, such as food protein-induced allergic proctocolitis and food protein-induced enteropathy. We examine the 2017 International Consensus Guidelines for FPIES, which established the first systematic mechanism for its diagnosis and treatment and were followed by a 2019 position paper from the European Academy of Allergy and Clinical Immunology. The authors examined recent studies that endorse FPIES as a diagnosis for children, highlight the issue of delayed diagnosis, highlight the need for better biomarkers, highlight current and popular food protein triggers, and find new methods for assessing tolerance.
If standardised diagnosis guidelines for non-IgE-mediated food allergies are established and prevalence data is increasingly published, these cases will likely be better recognised and evaluated. Large-scale prospective research examining their occurrence and prevalence, related risk factors, and natural background are currently needed. While avoidance of the suspected trigger food protein remains the core of treatment, further research into fundamental pathophysiology and disease biomarkers would most likely uncover new therapeutic avenues.
