Nahrungsmittelallergie und Histaminintoleranz

The number of patients reporting adverse reactions after eating normally harmless foods has increased significantly in recent years. It is often difficult to correctly identify the triggering food component. As a result, patients often follow inappropriately strict elimination diets of their own and are exposed to the risk of malnutrition. Food intolerances can be immunologically or non-immunologically mediated. A detailed medical history is an important part of the diagnosis of food intolerances. In IgE-mediated food allergies, the determination of specific IgEs in serum and a skin prick test are the basic diagnostic tests. The clinical appearance of food allergies is very diverse and can affect various organ systems (skin, eye, respiratory tract, gastrointestinal tract). Non-IgE-mediated food allergies or IgE-/non-IgE-mediated mixed forms are mainly characterized by gastrointestinal symptoms. Their diagnosis is often difficult due to a lack of biomarkers and is based on histopathological appearance and clinical symptoms. The treatment of food allergies consists of an elimination diet. Due to the possible spontaneous development of tolerance, diets should be checked and adjusted at regular intervals to avoid unnecessarily strict dietary restrictions. Histamine intolerance is one of the non-immunologically caused intolerances. An imbalance between histamine intake and breakdown leads to a wide range of clinical symptoms. Diets low in histamine should lead to rapid symptom relief. The detection of reduced diamine oxidase activity can confirm the diagnosis.