title: Awareness of allergic enterocolitis among primary-care paediatricians: A web-based pilot survey.
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%.
  
  
  CONCLUSIONS
  There is a need for promoting awareness of FPIES to minimise delay in diagnosis and unnecessary diagnostic and therapeutic interventions.
authors: Pediatric Clinic, Department of Life and Reproduction Sciences, University of Verona, Italy.
authors: P
authors: P
authors: Comberiati
authors: National System of Pediatric Primary Care, Asl To 1, Turin, Italy.
authors: M
authors: M
authors: Landi
authors: Pediatric Department, Santa Corona Hospital, Garbagnate Milanese, Milan, Italy.
authors: A
authors: A
authors: Martelli
authors: Pediatric Clinic, Department of Life and Reproduction Sciences, University of Verona, Italy.
authors: G L
authors: GL
authors: Piacentini
authors: Department of Pediatrics, Second University of Naples, Italy.
authors: C
authors: C
authors: Capristo
authors: Pediatric Clinic, Department of Life and Reproduction Sciences, University of Verona, Italy.
authors: G
authors: G
authors: Paiola
authors: Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Italy. Electronic address: diego.peroni@unipi.it.
authors: D G
authors: DG
authors: Peroni
mesh_terms: D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence / Q000706:statistics & numerical data*; D004760:Enterocolitis / Q000175:diagnosis / Q000453:epidemiology*; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D020407:Internet; D007558:Italy / Q000453:epidemiology; D000072143:Pediatricians / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Allergy; Children; Food allergy; Food protein-induced enterocolitis syndrome; Internet; Knowledge; Paediatricians; Questionnaire; Sensitivity; Survey