Awareness of allergic enterocolitis among primary-care paediatricians: A web-based pilot survey

P. Comberiati; M. Landi; A. Martelli; G.L. Piacentini; C. Capristo; G. Paiola; Diego Peroni

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Awareness of allergic enterocolitis among primary-care paediatricians: A web-based pilot survey

P. Comberiati ^[1] ; M. Landi ^[5] ; A. Martelli ^[2] ; G.L. Piacentini ^[1] ; C. Capristo ^[3] ; G. Paiola ^[1] ; D.G. Peroni ^[4]
1. [1] University of Verona
  
  University of Verona
  
  Verona, Italia
2. [2] Ospedale Santa Corona
  
  Ospedale Santa Corona
  
  Pietra Ligure, Italia
3. [3] Second University of Naples
  
  Second University of Naples
  
  Caserta, Italia
4. [4] University of Pisa
  
  University of Pisa
  
  Pisa, Italia
5. [5] National System of Pediatric Primary Care, Asl To 1, Turin, Italy
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Localización: Allergologia et immunopathologia: International journal for clinical and investigate allergology and clinical immunology, ISSN-e 1578-1267, ISSN 0301-0546, Vol. 44, Nº. 5, 2016, págs. 461-466
Idioma: inglés
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Resumen
- 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.