PURPOSE OF THE STUDY.
Previous reports suggest that ondansetron can be beneficial to hasten resolution of acute food protein–induced enterocolitis syndrome (FPIES) reactions. This study describes additional cases of successful treatment of acute FPIES reactions with intramuscular ondansetron in pediatric patients.
Five children aged 13 months to 4 years with a known diagnosis of FPIES who were undergoing oral food challenges (OFCs). Patients’ previous reactions were to cow’s milk (CM) (3 patients) and egg (2 patients).
Five patients underwent a total of 6 OFCs for evaluation of FPIES to the foods to which they had previously reacted. After the onset of symptoms, ondansetron was administered (0.2 mg/kg) intramuscularly in all patients.
Ondansetron intramuscular administration resulted in prompt resolution (within 15 minutes) of symptoms in all 6 OFCs, including 2 severe reactions characterized by pallor and lethargy. Efficacy was also observed in 1 case where ondansetron was administered 90 minutes after the onset of symptoms.
These cases add further support for the efficacy of ondansetron in the treatment of acute FPIES reactions during oral food challenges in young children. In addition to use in the medical setting, intramuscular ondansetron may provide an option for early treatment of FPIES before arrival at a medical facility.
Current treatment of acute FPIES reactions relies on rehydration and administration of steroids. These cases illustrate the effective use of ondansetron in hastening the resolution of acute FPIES reactions. Further studies with controls are needed to validate these findings and define the role of ondansetron in managing FPIES reactions.
- Copyright © 2015 by the American Academy of Pediatrics