Food protein-induced enterocolitis syndrome: a food allergy in the middle of the ford

We report on a paediatric patient that presents simultaneously a food allergy (FA) with clinical manifestations of both food protein-induced enterocolitis syndrome (FPIES) and IgE-mediated FA to cow's milk and a classic non-IgE-mediated FPIES to peanut. This has implications from both a speculative and a clinical point of view. Indeed, we do not consider it sufficient to define FPIES as a non-IgE-mediated FA. There are numerous indications that suggest a role for IgE in at least some patients. Therefore, we would prefer it to be classified as a mixed form. Some patients, such as the one described in our paper, are definable as 'in the middle of the ford'. From a clinical point of view, the identification of a role for specific IgE could hypothetically facilitate the choice of certain dietary indications, such as testing tolerance to processed cow's milk derivatives.