Food Protein-Induced Enterocolitis Syndrome Causing Hypovolemic Shock and Methemoglobinemia

A 5-week-old previously healthy male presented with vomiting and diarrhea leading to hypovolemic shock and profound metabolic acidosis. He was subsequently found to have severe methemoglobinemia. The acidosis and shock improved with fluid resuscitation and methemoglobinemia was successfully treated...

Full description

Saved in:
Bibliographic Details
Main Authors: Stefan W. Malin, Riad Lutfi, Matthew L. Friedman, Alicia M. Teagarden
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2018/1903787
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849690816740589568
author Stefan W. Malin
Riad Lutfi
Matthew L. Friedman
Alicia M. Teagarden
author_facet Stefan W. Malin
Riad Lutfi
Matthew L. Friedman
Alicia M. Teagarden
author_sort Stefan W. Malin
collection DOAJ
description A 5-week-old previously healthy male presented with vomiting and diarrhea leading to hypovolemic shock and profound metabolic acidosis. He was subsequently found to have severe methemoglobinemia. The acidosis and shock improved with fluid resuscitation and methemoglobinemia was successfully treated with methylene blue. An extensive workup, including evaluations for infectious and metabolic etiologies, was unremarkable. However, a detailed dietary history revealed a recent change in diet, supporting a diagnosis of food protein-induced enterocolitis syndrome (FPIES). We present this case to highlight the importance of considering FPIES in an infant with vomiting and diarrhea, in the setting of a recent dietary change, leading to profound dehydration, metabolic acidosis, and methemoglobinemia. Diagnosis of FPIES, although difficult to make and one of exclusion, can be potentially life-saving.
format Article
id doaj-art-ed89ead1a97d4aada352ddd2c70d27ea
institution DOAJ
issn 2090-6420
2090-6439
language English
publishDate 2018-01-01
publisher Wiley
record_format Article
series Case Reports in Critical Care
spelling doaj-art-ed89ead1a97d4aada352ddd2c70d27ea2025-08-20T03:21:12ZengWileyCase Reports in Critical Care2090-64202090-64392018-01-01201810.1155/2018/19037871903787Food Protein-Induced Enterocolitis Syndrome Causing Hypovolemic Shock and MethemoglobinemiaStefan W. Malin0Riad Lutfi1Matthew L. Friedman2Alicia M. Teagarden3Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USADivision of Pediatric Critical Care, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USADivision of Pediatric Critical Care, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USADivision of Pediatric Critical Care, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USAA 5-week-old previously healthy male presented with vomiting and diarrhea leading to hypovolemic shock and profound metabolic acidosis. He was subsequently found to have severe methemoglobinemia. The acidosis and shock improved with fluid resuscitation and methemoglobinemia was successfully treated with methylene blue. An extensive workup, including evaluations for infectious and metabolic etiologies, was unremarkable. However, a detailed dietary history revealed a recent change in diet, supporting a diagnosis of food protein-induced enterocolitis syndrome (FPIES). We present this case to highlight the importance of considering FPIES in an infant with vomiting and diarrhea, in the setting of a recent dietary change, leading to profound dehydration, metabolic acidosis, and methemoglobinemia. Diagnosis of FPIES, although difficult to make and one of exclusion, can be potentially life-saving.http://dx.doi.org/10.1155/2018/1903787
spellingShingle Stefan W. Malin
Riad Lutfi
Matthew L. Friedman
Alicia M. Teagarden
Food Protein-Induced Enterocolitis Syndrome Causing Hypovolemic Shock and Methemoglobinemia
Case Reports in Critical Care
title Food Protein-Induced Enterocolitis Syndrome Causing Hypovolemic Shock and Methemoglobinemia
title_full Food Protein-Induced Enterocolitis Syndrome Causing Hypovolemic Shock and Methemoglobinemia
title_fullStr Food Protein-Induced Enterocolitis Syndrome Causing Hypovolemic Shock and Methemoglobinemia
title_full_unstemmed Food Protein-Induced Enterocolitis Syndrome Causing Hypovolemic Shock and Methemoglobinemia
title_short Food Protein-Induced Enterocolitis Syndrome Causing Hypovolemic Shock and Methemoglobinemia
title_sort food protein induced enterocolitis syndrome causing hypovolemic shock and methemoglobinemia
url http://dx.doi.org/10.1155/2018/1903787
work_keys_str_mv AT stefanwmalin foodproteininducedenterocolitissyndromecausinghypovolemicshockandmethemoglobinemia
AT riadlutfi foodproteininducedenterocolitissyndromecausinghypovolemicshockandmethemoglobinemia
AT matthewlfriedman foodproteininducedenterocolitissyndromecausinghypovolemicshockandmethemoglobinemia
AT aliciamteagarden foodproteininducedenterocolitissyndromecausinghypovolemicshockandmethemoglobinemia