Pathogenesis (development of disease) The term pseudoallergy is used to describe intolerance symptoms that are similar to those of allergy. However, unlike allergy, the cause is nonimmunologic, meaning that there is no hypersensitivity reaction of the immune system to the foreign substance. Pseudoallergic reactions are based on a disposition of the affected person, i.e. on … Pseudoallergy: Causes
The following are the most important diseases or complications that may be contributed to by pseudoallergy: Injuries, poisonings, and certain other sequelae of external causes (S00-T98). Anaphylactic shock (anaphylaxis) – most severe allergic reaction that can lead to respiratory and circulatory arrest. Psyche – nervous system (F00-F99; G00-G99). Anxiety
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Skin, mucous membranes [pruritus (itching); contact dermatitis or contact dermatitis (redness and swelling of the skin, pruritus (itching), burning, development of small vesicles, scaling); urticaria (hives); … Pseudoallergy: Examination
2nd order laboratory parameters – depending on the results of the medical history, physical examination, etc. – for differential diagnostic clarification Histamine (blood, plasma, urine). Diamine oxidase (DAO)* – marker for the diagnosis of histamine intolerance and associated clinical pictures; if DAO deficiency or inhibition is present, the organism cannot break down histamine ingested with … Pseudoallergy: Test and Diagnosis
Hypersensitivity to food additives, salicylic acid, and flavorings The pathomechanism of nonallergic hypersensitivity reactions to food additives, salicylic acid, and flavoring agents is poorly understood. They are thought to be based on nonIgE-mediated allergy or to underlie enzyme inhibition.Jäger believes that the following factors may be responsible for the development of pseudoallergy: Mediator release, for … Pseudoallergy: Food Additives
Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification. H2 breath test due tosuspicion of lactose, fructose or sorbitol malabsorption. Instructions for performing the examination! Do not eat carbohydrate-rich meals the day before the examination and prefer meals that are fiber-free. … Pseudoallergy: Diagnostic Tests
To prevent pseudoallergy, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Foods high in vaso- or psychoactive biogenic amines (naturally occurring flavor and taste compounds found in foods, such as tyramine, serotonin, histamine, synephrine, feruloylputrescine, putrescine, cadaverine, spermidine, spermine) Foods that lead to increased histamine release such as strawberries, chocolate, … Pseudoallergy: Prevention
The following symptoms and complaints may indicate a pseudoallergy: Pruritus* (itching). Dyspnea (shortness of breath) Contact dermatitis or contact eczema (redness* and swelling of the skin, pruritus (itching), burning, development of small vesicles, scaling). Cough Sneezing (sneezing fits), rhinitis (running nose, runny nose). Nasal congestion Stuffy nose* Allergic rhinoconjunctivitis (symptomatic hypersensitivity reaction of the nose, … Pseudoallergy: Symptoms, Complaints, Signs
General measures If there is an intolerance to excipients in medicines, a change of preparation should be made. Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day) – alcohol increases the absorption (uptake) of histamine. Review of permanent medication due topossible effect on the existing disease. Nutritional … Pseudoallergy: Therapy
Medical history (history of illness) represents an important component in the diagnosis of pseudoallergy. Family history Are there people in your family with “allergies”? Social anamnesis Current medical history/systemic medical history (somatic and psychological complaints). Have you noticed any symptoms on the skin such as redness or itching related to food/medication intake, etc.? Have you … Pseudoallergy: Medical History
Hypersensitivity to biogenic aminesBiogenic amines include, for example: Histamine (most important representative, especially in cheese, wine, fish, smoked meat products, spinach and tomatoes – when these foods spoil, their histamine content increases). Cadaverine (contained mainly in cereal sprouts and sauerkraut). Feruloylputrescine (found in grapefruit). Phenylethylamine Putrescine* (especially in cereal sprouts and sauerkraut). Serotonin (in migraine … Pseudoallergy: Biogenic Amines
Diagnosis of pseudoallergy consists of: Karenzdiät Oral provocation test – elimination of symptom-triggering foods, with exposure over 2-3 weeks to observe the onset of symptoms. Laboratory diagnostics (see below).
