The research articles report 20% of FPIES kids experience full shock.
Shock is very serious, and any symptoms of reactions should be discussed and outlined with your child's doctor.
Shock in FPIES kids can be obvious but there are also symptoms of late-shock that can be confusing but remain very serious and concerning. It is beneficial for your child to have an ER letter (click here for sample) for treatments, that outlines the need for IV hydration and montioring following a reaction.
I found this article on Pediatic Shock to be very educational. I, personally, have had to learn from my son's reactions as I didnt' recognize his body going into shock, because he hasn't gone into immediate shock but does go into late-shock.
The shock and dehydration is not necessarily proportionate to the volume depleted (my son took in 70oz. the days following a vomiting reaction and he still had dehyration when checked 3days later!). Every child is different and all reactions should be taken seriously, and assessed carefully.
This is another area where more research would benefit. The dehydration and shock can come from the capilary leakage that happens from the inflammatory response actions. For further reading:: Complement activation in relation to capillary leakage in Children with septic shock and purpura. It does not address FPIES specifically but sheds some light on the activations of the inflammatory process.
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