Author Topic: is MSPI Different then FPIES?  (Read 3632 times)

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Offline green100

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is MSPI Different then FPIES?
« on: May 29, 2013, 17:48:52 pm »
Our family doc referred us to a pediatric allergist/immunologist because DD has had ongoing issues with what i'm pretty confident is somesort of intolerance to milk and soy - excessive spitting up and eczema when exclusively breastfeeding resolved when i cut milk out, when tried to introduce milk after age one first two times deveolped cold like symptoms, third time seemed to tolerate it then after 2 months developed diarrhea for weeks until we cut out all cheese and yogurt too. After a hiatus from those products we were able to reintroduce yogurt and cheese, but the moment we gave her milk diarrhea and the worst diaper rash. Then a month later she started vomitting over night, at first we thought gastro, but she was fine duringthe day. Cut out dairy products, but still had episodes of vomitting at night sometimes. Then i took a closer look at products and saw they unexpectedly had milk in them, so we started reading labels and she wss good for several months. Trying to find a cheese alternative, gave her soy cheese and the vomitting returned, also noted vomitting after a soy based sauce was eaten. Now we avoid both soy and milk.

Ped analysis is that it is not FPIES because her vomitting is more then 4 hours after eating and it's not violent enough - not so dehydrated that we have to go to the hospital. Ped ruled out histamine mediated allergic reaction. So her thought is that DD is having vomitting due to post nasal drip. She has recommended we reintroduce milk lactose free to rule out lactose intolerance.  If she has a response, she then wants to send us to a pediatric gastro-enterologist for endoscopy to rule out a form of reflux caused by specific foods. 

Now i'm just wondering is there a difference between MSPI and FPIES, or is MSPI just naming the specific food protein intolerance? I would agree that DD symptoms don't fit the typical FPIES, so wondering if she could still have some sort of intolernce or sensitivity because I'm starting to feel a little crazy....my family doc felt DD had bronchitis and excessive coughing was causing the vomitting - i fought really hard on this because she only coughed during the night (you'd think during daytime too with bronchitis) and only on the nights that she vomitted -pretty sure the coughing was to prevent aspiration of the vomit. I eventually caved in to accepting antibiotics so that i could get a referral to a specialist. And now the specialist is suggesting post nasal drip!

We are going to try lactose free milk after we go on vacation. But in the mean time i wanted to figure out if there is a difference between MSPI and FPIES, and to vent my frustrations a little!! It'll be awhile til we can try the lactose free milk, just in case she does have a response i don't want her to have diarrhea while we are away.

Offline Buntybear

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Re: is MSPI Different then FPIES?
« Reply #1 on: May 30, 2013, 18:47:34 pm »
Hi there,

How old is your LO? I am afraid I have no experience of FPIES so have asked for help on that aspect.

It sounds like your gut instinct of milk and soy is correct TBH. Too many doctors just do not consider reactions to foods to be the cause of symptoms like these.

Is the coughing accompanied by wheezing? Could it be a bit of asthma?
x

Offline deb

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Re: is MSPI Different then FPIES?
« Reply #2 on: May 30, 2013, 19:30:55 pm »
Post-nasal drip could easily be caused by dairy as dairy can be related to mucous production. Not sure about MSPI vs FPIES, but if dairy is a trigger for the other symptoms, by all means do keep dairy at a minimum for now, at least uncultured dairy.

Offline ENMS

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Re: is MSPI Different then FPIES?
« Reply #3 on: May 31, 2013, 00:02:08 am »
(((hugs)))

My DS was believed to have FPIES for some time but fortunately for us he doesn't have FPIES. Drs have various definitions of FPIES... My DS had diarrhea, and the allergist still diagnosed his with FPIES initially, while I know some Drs will not diagnose FPIES without profuse vomiting (to lethargy).

I think at the end of day your instinct is most likely right. And don't forget also that FPIES is just a name put on a group of symptoms really. So it definitely sounds like she has a serious intolerance to milk and soy. Is it an FPIES intolerance, it is possible, but either way the treatment would not change, kwim? Some LO's are FPIES to milk and soy only, and others are FPIES to tons of foods.

Do give a try to lactose free milk you will know but it could be the lactose or it could also be the protein she is intolerant to. If she has similar reactions to milk and soy, my bet would be on the protein since the proteins in milk and soy are very similar.

I agree with Deb that dairy can cause post nasal drip so it could just be that, but if she has serious vomiting I guess there may be more at play here.
Elise



Offline ZacsMumme

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Re: is MSPI Different then FPIES?
« Reply #4 on: May 31, 2013, 02:56:15 am »
Agree with Elise.
Here is some info on FPIES http://www.kidswithfoodallergies.org/resourcespre.php?id=99
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Offline green100

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Re: is MSPI Different then FPIES?
« Reply #5 on: June 25, 2013, 14:34:09 pm »
Thanks for the responses. Sorry for my delayed response. LO is 27 months now. I don't think it's asthma, with her runny nose you can hear the wet breathing, but it's not wheezing.

My DH was impatient prior to our trip so we tried some lactose free milk mixed in with her hemp milk. After 3 days she started developing a rash so we stopped because we were going on our trip. Rash resolved quickly. We are now back and tried again, rash returned, and she has deveolped two spots of eczema on her face. She also had a crazy fever and had a febrile seizure, reason for fever they think is pneumonia. As i mentioned before when she was just over a year and we tried introducing milk 2x she got sick and we stopped the milk. Maybe it depresses her immune system in some way?

I agree that treatment is the same either way (no milk and soy) but i just want some confirmation medically.  I'm starting to think that won't happen and i should just go with my gut feeling. I do have a call into the pediatrician, we'll see what she says. 

Thanks again for the responses and confirmation of my thoughts.

Offline ZacsMumme

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Re: is MSPI Different then FPIES?
« Reply #6 on: June 25, 2013, 20:53:16 pm »
Hugs. Pneumonia must be scary. I hope she is recovering ok.
Have drs considered aspiration?
***Sara***
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DS1 - Our sensitive soul. Silent reflux.

DS2 Our cheeky chipmunk. Reflux, MSPI.

Offline green100

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Re: is MSPI Different then FPIES?
« Reply #7 on: July 03, 2013, 17:45:17 pm »
Recovery was uneventful. Her only symptom of the pneumonia was fever and she was back to her usual go-go-go self quickly.

When i brought up the milk issue with the ER doc, i was shot down pretty quickly and was told it absolutely could not be related.  Though i never specifically suggested aspiration.

Pediatrician got back to me, well i received a message from her secretary in response to my concern - diaper rash is not a sign of an allergy and eczema is but only if it covers the whole body,  but we should discontinue the milk and try again once the symptoms have resolved. If she gets a diaper rash again then she is going to send her for blood tests. Since i didn't speak to her directly i don't know what for.

We'll try again soon.

Offline ZacsMumme

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Re: is MSPI Different then FPIES?
« Reply #8 on: July 03, 2013, 19:46:11 pm »
:-\ um diaper rash IS a sign of an allergy. So is a small amounts of eczema ::)
http://www.neocate.co.nz/understanding-cma/symptoms

So what is your peds current recommendation for going forward?
***Sara***
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DS1 - Our sensitive soul. Silent reflux.

DS2 Our cheeky chipmunk. Reflux, MSPI.

Offline green100

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Re: is MSPI Different then FPIES?
« Reply #9 on: July 03, 2013, 20:12:30 pm »
She's recommending we try again after the symptoms have cleared up, which they have, if she develops them again then she wants to do a blood test.

Offline ZacsMumme

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Re: is MSPI Different then FPIES?
« Reply #10 on: July 03, 2013, 20:16:55 pm »
That sounds reasonable. :)
Glad she recovered quickly!
***Sara***
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DS1 - Our sensitive soul. Silent reflux.

DS2 Our cheeky chipmunk. Reflux, MSPI.

Offline green100

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Re: is MSPI Different then FPIES?
« Reply #11 on: July 03, 2013, 20:23:25 pm »
That website was interesting, thanks for the link.  The pediatrician has said though her symptoms may be similar to an allergic reaction, they aren't severe enough eg. She doesn't vomit to dehydration, the eczema is not all over her body.  Certainly i'm ok with DD not having an allergy, but she doesn't tolerate milk products for sure, and even without a Dx, as someone previously mentioned the treatment is the same.