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Vol. 44. Issue 5.
Pages 461-466 (September - October 2016)
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Vol. 44. Issue 5.
Pages 461-466 (September - October 2016)
Original Article
DOI: 10.1016/j.aller.2016.03.002
Awareness of allergic enterocolitis among primary-care paediatricians: A web-based pilot survey
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P. Comberiatia, M. Landib, A. Martellic, G.L. Piacentinia, C. Capristod, G. Paiolaa, D.G. Peronie,
Corresponding author
diego.peroni@unipi.it

Corresponding author.
a Pediatric Clinic, Department of Life and Reproduction Sciences, University of Verona, Italy
b National System of Pediatric Primary Care, Asl To 1, Turin, Italy
c Pediatric Department, Santa Corona Hospital, Garbagnate Milanese, Milan, Italy
d Department of Pediatrics, Second University of Naples, Italy
e Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Italy
Article information
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Tables (2)
Table 1. Clinical vignettes of suspected cases of FPIES. Multiple answers were allowed.
Table 2. Survey respondents’ opinion on diagnostic and therapeutic features of FPIES.
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Abstract
Background

Allergic enterocolitis, also known as food protein-induced enterocolitis syndrome (FPIES), is an increasingly reported and potentially severe non-IgE mediated food allergy of the first years of life, which is often misdiagnosed due to its non-specific presenting symptoms and lack of diagnostic guidelines.

Objective

We sought to determine the knowledge of clinical, diagnostic and therapeutic features of FPIES among Italian primary-care paediatricians.

Methods

A 16-question anonymous web-based survey was sent via email to randomly selected primary care paediatricians working in the north of Italy.

Results

There were 194 completed surveys (48.5% response rate). Among respondents, 12.4% declared full understanding of FPIES, 49% limited knowledge, 31.4% had simply heard about FPIES and 7.2% had never heard about it. When presented with clinical anecdotes, 54.1% recognised acute FPIES and 12.9% recognised all chronic FPIES, whereas 10.3% misdiagnosed FPIES as allergic proctocolitis or infantile colic. To diagnose FPIES 55.7% declared to need negative skin prick test or specific-IgE to the trigger food, whereas 56.7% considered necessary a confirmatory oral challenge. Epinephrine was considered the mainstay in treating acute FPIES by 25.8% of respondents. Only 59.8% referred out to an allergist for the long-term reintroduction of the culprit food. Overall, 20.1% reported to care children with FPIES in their practice, with cow's milk formula and fish being the most common triggers; the diagnosis was self-made by the participant in 38.5% of these cases and by an allergist in 48.7%.

Conclusion

There is a need for promoting awareness of FPIES to minimise delay in diagnosis and unnecessary diagnostic and therapeutic interventions.

Keywords:
Allergy
Children
Food allergy
Food protein-induced enterocolitis syndrome
Knowledge
Internet
Paediatricians
Questionnaire
Sensitivity
Survey
Abbreviations:
CM
FPIES
OFC
SPT

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