Use of ondansetron for food protein–induced enterocolitis syndrome

To the Editor: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by severe, repetitive vomiting that begins about 2 hours after the ingestion of the problem food.1-3 Diarrhea may also occur, and reactions typically result in acute dehydration, frequ...

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Bibliographic Details
Published in:Journal of allergy and clinical immunology 2013-11, Vol.132 (5), p.1219-1220
Main Authors: Holbrook, Teri, RN, MS, CPNP, Keet, Corinne A., MD, MS, Frischmeyer-Guerrerio, Pamela A., MD, PhD, Wood, Robert A., MD
Format: Article
Language:English
Subjects:
Abdomen
Allergy and Immunology
Chemotherapy
Child
Child, Preschool
Emergency medical care
Enterocolitis - drug therapy
Enterocolitis - immunology
Female
Fluids
Food
Food Hypersensitivity - drug therapy
Food Hypersensitivity - immunology
Humans
Male
Medical treatment
Ondansetron - administration & dosage
Ondansetron - therapeutic use
Pain
Proteins
Proteins - adverse effects
Serotonin
Serotonin Antagonists - administration & dosage
Serotonin Antagonists - therapeutic use
Treatment Outcome
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Summary:To the Editor: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by severe, repetitive vomiting that begins about 2 hours after the ingestion of the problem food.1-3 Diarrhea may also occur, and reactions typically result in acute dehydration, frequently with hypotension, shock, acidemia, and methemoglobinemia. Ondansetron hydrochloride is a highly potent and selective serotonin 5-HT3 receptor antagonist that is approved for use in preventing and treating nausea and vomiting induced by chemotherapy and radiation, with a low risk of adverse effects.4 Recently, ondansetron has been used successfully off-label in emergency room settings to control vomiting, such as in acute gastroenteritis.5,6 Significant side effects are uncommon and unlike other antiemetics, ondansetron does not have the safety concerns of excessive drowsiness or extrapyramidal reactions, although special caution may be warranted in children with underlying heart disease, as QT prolongation has been observed.
ISSN:0091-6749
1097-6825
DOI:10.1016/j.jaci.2013.06.021