Understanding Lab Tests for Food Protein-Induced Enterocolitis Syndrome (FPIES)
Written by Private MD Labs Medical Writing Team • Last Updated: September 8, 2025
Food Protein-Induced Enterocolitis Syndrome (FPIES) is a severe non-IgE mediated food allergy that primarily affects the gastrointestinal system, causing delayed vomiting, diarrhea, and in severe cases, shock. FPIES is primarily diagnosed through clinical evaluation and food elimination trials. While there is no single blood test that can definitively diagnose FPIES, laboratory testing plays a supportive role in identifying potential trigger foods and managing the condition.
Top Recommended Test
Allergen Specific IgE Rice Wild
This test detects IgE antibodies against wild rice proteins. Rice is a known trigger food for FPIES, particularly in infants and children. The presence of allergen-specific IgE to rice may help identify rice as a causative agent and support the clinical diagnosis of FPIES in patients experiencing delayed gastrointestinal reactions.
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The Role of Blood Testing in FPIES
Since FPIES reactions are typically delayed and can be triggered by various foods, blood tests are fundamental for identifying specific food allergens that may be causing symptoms. These tests help healthcare providers develop appropriate elimination diets and guide reintroduction protocols, which are essential components of FPIES management.
Other Relevant Tests
Allergen Specific IgEÂ Tilapia
This test measures IgE antibodies specific to tilapia fish protein. While FPIES is typically non-IgE mediated, some patients may have concurrent IgE reactions to fish proteins. High levels may suggest tilapia as a potential trigger food in FPIES patients, helping guide dietary elimination strategies.
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Lemon (f208) IgG
This test measures IgG antibodies to lemon proteins. While FPIES commonly involves proteins from milk and soy, some patients may react to citrus fruits like lemons. Elevated IgG levels may indicate immune system recognition of lemon proteins, potentially supporting identification of lemon as a trigger food in FPIES management.
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Understanding Test Results in FPIES Context
It's important to note that FPIES reactions are primarily cell-mediated rather than antibody-mediated. These blood tests provide supportive information but must be interpreted alongside clinical symptoms, food diaries, and supervised food challenges when appropriate. The presence of specific antibodies may help identify potential trigger foods, but the absence of antibodies does not rule out FPIES.
Important Considerations
The information here is for educational purposes only and is not a substitute for professional medical advice. FPIES diagnosis and management should always involve specialized healthcare providers experienced in food allergies. Always consult with a healthcare provider for proper diagnosis and treatment.
