Note that this is a bulk suggestion for two cards but they are basically the exact same change for both cards for the same reasoning.
Previously discussed in slack - FPIAP does not present with failure to thrive. This card kinda sucks and may need improvement, but it is not referring to FPIAP
Hi, I think there has been some confusion @herstein.jacob
I do not recall this discussion in the maintainer chat, perhaps it was before my time or I just overlooked it. I agree this card is not referring to FPIAP, but that is not what I was suggesting.
MY suggestion is for this answer to be FPIES. This is the description of FPIES on AMBOSS from the link I included in the rationale (emphasis added).
A non-IgE-mediated food allergy primarily seen in infants. Caused by non-IgE-mediated inflammation of the entire gastrointestinal tract in response to food proteins (e.g., cow’s milk, soy protein). Symptoms typically include vomiting, diarrhea, weight loss, and failure to thrive.
To provide a terse summary of the information contained in the links I included in the rationale, FPIAP and FPIES are both non-IgE inflammation of GI tract. FPIAP is distal GI tract only and less severe, while FPIES is the entire GI tract, significantly more severe, has acute and chronic presentations that include progressive vomiting and bloody diarrhea and the chronic presentation is specifically noted to have failure to thrive (this comes up in UTD and AMBOSS). My understanding is that we aren’t 100% certain how related their etiologies are, other than both being non-IgE.
As I mentioned in the rationale, the AMBOSS definition of cow’s milk allergy is not really consistent with this note in the sense that this note leaves out all the most significant symptoms (anaphylactic stuff). AMBOSS says cow’s milk allergy is a typical IgE food allergy, and this card does not match a typical food allergy. See link in rationale.
As I also mentioned, UTD allows for the possibility that cow’s milk allergy could be used as an umbrella term including FPIAP and FPIES, while AMBOSS does not. UTD helps clear up this inconsistency though, I think, because it basically insinuates that everything used to be cow’s milk allergy and now we should use more specific, descriptive labels for these different conditions.
I did misunderstand, my apologies for rejecting quickly - and yes, discussion happened several months back.
That said, I did a ton of reading on this at the time and I think we were not thrilled with the potential change since FPIES is not even included in the AMBOSS article and, as far as I recall, was not part of UW either. Would be very beneficial if we could try to confirm the change to FPIAP with UW or AMBOSS q-banks since this is removing a concept entirely from the deck.