Criteria for the suspicion and diagnosis of acute food protein-induced enterocolitis syndrome.

Over the past decades, several panels of criteria have been proposed for the diagnosis of acute food protein-induced enterocolitis syndrome (FPIES). However, none of them have been validated by a prospective study. Such a study is not easy to carry out, because even the children who most of us would certainly believe to be suffering from acute FPIES, possibly serious, should be subject to oral food challenge (OFC). Moreover, the presence of different phenotypes of the acute FPIES may mean that some of them do not fit into any of the above criteria panels. Particularly, Vazquez-Ortiz et al. reported that milder cases (1/4 in their Southern European cohort) might not be captured by the 2017 Consensus diagnostic criteria, which are the most shared till date. Those authors, as well as all interested researchers, claim for accurate diagnostic bio-markers which, however, are not available at the moment.