J ALLERGY CLIN IMMUNOL

VOLUME 133, NUMBER 2

Abstracts AB213

MONDAY

739 Food Allergy Testing Practices Of Primary Care PediatriciansIn Illinois

Hector Rodriguez, MD1,2, Ms. Claudia Lau1, Dr. Ruchi Gupta, MD,

MPH1,2, Melanie M. Makhija, MD1,3; 1Ann and Robert H. Lurie Chil-

dren’s Hospital of Chicago, Chicago, IL, 2Northwestern University Fein-

berg School of Medicine, Chicago, IL, 3Division of Allergy &

Immunology, Department of Pediatrics,Northwestern University Feinberg

School of Medicine, Chicago, IL.

RATIONALE: There is increasing need for pediatricians to appropriately

diagnosis andmanage food allergies given rising prevalence. As recently as

2010, physicians acknowledged limitations in their understanding of food

allergy and the interpretation of its diagnostic studies. It is in this context

that we assessed the food allergy management practices of pediatricians in

Illinois.

METHODS: Online surveys were distributed to pediatricians in

Chicago and surrounding area (urban and suburban Illinois). The

survey assessed current food allergy testing and management practices.

Basic statistical tests and chi-squared analyses were performed using

STATA/SE 12.1.

RESULTS: 217 physicians responded to the survey. 57% estimated a

food allergy prevalence in their practice of >6%. Specific IgE testing

was ordered by 78%, with food reaction being the most common

reason for testing (95%) followed by eczema (66.2%), parental

request (62.6%) and environmental allergy (49.6%). Restriction of

diet was recommended by 45.8% of respondents to prevent

development of food allergy, 17.5% of respondents to prevent atopic

dermatitis and 5.2% of respondents to prevent asthma. Food restric-

tion was recommended by 33% to manage atopic dermatitis. Of

those who manage children with food allergy, 94% of respondents

consistently prescribed autoinjectable epinephrine, 82.1% offered

education on allergen avoidance and 67.9% provided emergency

action plans.

CONCLUSIONS: Pediatricians order testing for allergies and recom-

mend food avoidance for both the prevention and management of

various atopic diseases. Most pediatricians in the Chicagoland area

offer education and prescribe autoinjectable epinephrine for their food

allergy patients.

740 Understanding The Role Of Online Resources For ChildhoodFood Allergies

David Goese1, Ves Dimov, MD2; 1University of Chicago Pritzker School

of Medicine, Chicago, IL, 2University of Chicago Medicine, Chicago, IL;

Section of Allergy, Asthma and Immunology, Department of Pediatrics,

Department of Medicine, University of Chicago, Chicago, IL.

RATIONALE: 59% of US adults searched for health information

online within the past year. The largest online childhood food allergy

forum, Kids With Food Allergies Foundation (KWFA), has 30,000+

registered users. Use of such web resources remains uncharacterized.

This study aims to define KWFA user demographics, identify

important KWFA features, and understand how KWFA affects the

lives of food-allergic families.

METHODS: A 23-question mixed-methods quantitative and qualitative

survey was administered starting June 7, 2013 on the KWFA forum

website, KWFA Facebook page, and KWFA e-newsletter. N 5 104 study

participants met inclusion criteria of being a KWFA user over 18 years old.

All data was collected anonymously.

RESULTS: Survey respondents were 93% women, 89% Caucasian,

and 62% were between age 36-50. 69% had dealt with food allergies

for 3 or more years. The most commonly used resources were

KWFA’s e-newsletter, forum, and recipe index. Users reported the

forum as the most valuable resource. 24% of respondents visit the

forum once a day or more. Reasons for use include getting

information about latest allergy treatments, support from peers, and

ability to get second opinions. 13% chose a physician based on

forum information or recommendations. Most users agree that KWFA

reduces stress (76%) and influenced purchasing decisions (71%).

94% would recommend KWFA to other families raising food-allergic

children.

CONCLUSIONS: KidsWith Food Allergies Foundation online resources

influence users’ behavior, provide valued information and support, and

may have a role in the spectrum of childhood food allergy care as a source

of information and stress alleviation.

741 Clinical Features, Diagnosis, Management and NaturalHistory Of Food Protein-Induced Enterocolitis Syndrome In aNational Cohort

Dr. Todd David Green, MD, FAAAAI1, Dr. Matthew J. Greenhawt, MD,

MBA, MSc2, Dr. Tammy S. Jacobs, MD, MA1, Fallon Schultz3; 1Chil-

dren’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, 2Department of

Internal Medicine, The University of Michigan Medical School, Division

of Allergy and Clinical Immunology, Ann Arbor, MI, 3International Asso-

ciation for Food Protein Enterocolitis (IAFFPE).

RATIONALE: Food protein-induced enterocolitis syndrome (FPIES) is a

non-IgE mediated food allergic reaction. Current descriptive studies are

regionally limited to referral center populations.

METHODS: An internet survey examining characteristics of FPIES was

distributed nationally via email and social media networks of two support

organizations (International Association for Food Protein Enterocolitis

and Kids With Food Allergies Foundation).

RESULTS: Among 263 respondents to date, the most common

triggers were rice (61%), milk (57.9%), oat (48.8%), soy (47.2%),

sweet potato (26%), wheat (23.6%), and egg (23.2%). 70.1% reported

breastfeeding for >6 months, and 42.1% reported a reaction triggered

through breast-milk exposure. Co-morbid atopic conditions included

eczema (60.4%), allergic rhinoconjunctivitis (36.3%), IgE-mediated

food allergy (33.2%), and asthma (19.5%). 13.7% reported carrying an

epinephrine auto-injector for FPIES. Median reported age of milk

FPIES onset was 2 months, soy 5 months, and for the most common

solid foods between 5-7 months. 56.3% of milk and 28.2% of soy

reactions reportedly occurred before age two months. Profuse vomiting

occurred with 56.3% of milk, 82.1% of soy, and 95.8% of rice

reactions; lethargy occurred in 46% of milk, 79.5% of soy, and 87.4%

of rice reactions. Over half who outgrew FPIES reported undergoing

at-home challenge for initial re-introduction.

CONCLUSIONS: Common FPIES triggers were similar to previous

reports, though reported ages of onset for liquid and solid FPIES were

younger and the frequency of FPIES to oat and rice was higher. More

respondents than expected reported reactions triggered through breast

milk, carry epinephrine for FPIES reactions, and underwent at-home

challenge for food re-introduction.