1 ）Nowak-Wegrzyn A‚ Katz Y‚ Mehr SS‚ Koletzko S: Non-
milk allergy in NICU neo- nates. Allergology International‚
62: 85-90‚ 2013.
IgE-mediated gastrointestinal food allergy. The Journal of
8 ）Miceli Sopo S‚ Monaco S‚ Cerchiara G‚ Bersani G: A very
Allergy and Clinical Immunology‚ 135: 1114-1124‚
unusual case of food allergy‚ between FPIES and IgE-
2015.
mediated food allergy. European Annals of Allergy and
2 ）厚生労働省難治性疾患研究班疾患研究班，新生児─
534
survey on food–related symptoms suggestive of cow's
Clinical Immunology‚ 49: 42-44‚ 2017.
FPIES の非典型的な皮膚症状
Abstract
FOOD PROTEIN-INDUCED ENTEROCOLITIS SYNDROME(FPIES)
CAUSES HYPOVOLEMIC SHOCK IN ACUTE PHASE AND ATYPICAL
ERYTHEMA INLATE PHASE: A CASE REPORT
Atsushi Takahashi 1 ）, Michihiro Hatano 2 ，3 ）, Mari Iwamoto 2 ）
1）
Department of Pediatrics, Odawara Municipal Hospital
2）
Department of Pediatrics, Saiseikai Yokohamashi Tobu Hospital
3）
Hatano Higashikanagawa Kids Clinic
We describe a case of food protein-induced enterocolitis syndrome (FPIES) with abrupt onset of gastrointestinal
symptoms that precipitated a shock state with atypical erythema on the trunk following an oral food challenge test
(OFC) performed in late infancy. No symptom was noticed until day 7. On day 8, the patient had repeated episodes
of vomiting and then entered a shock state, at which point he was transferred to our hospital. After a bolus infusion
of saline, his general condition improved. He was subsequently managed with fluid infusion and antibiotics and was
given nothing perorally. Once he recovered good general condition, feeding with amino-acid formula was initiated
without any gastrointestinal symptoms. Laboratory tests were negative for serum immunoglobulins E for cow's milk,
casein, α-lactalbumin, and β-lactoglobulin. An allergen-specific lymphocyte stimulation test (ALST) for lactoferrin
was positive. After excluding other differential diagnoses, a diagnosis of FPIES was made following clinical
improvement with elimination of cow's milk formula. A infant formula OFC was performed at thirteen months of
age, and the patient showed no gastrointestinal symptoms but erythema on his trunk.
If assessed strictly the result of the test was negative for FPIES, although the possibility that the erythema may be
an atypical presentation of FPIES cannot be rejected. More cases are necessary to evaluate this erythema further.
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