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 noticed symptoms such as sneezing (sneezing fits), coughing, or shortness of breath in temporal relation to food intake?
- Have you noticed symptoms such as stool irregularities in temporal relation to food intake?
- Have you noticed symptoms such as headaches or rapid heartbeat?
- Do you suffer from nausea or vomiting afterwards?
- Do you have abdominal pain?
- Do you have flatulence?
- When exactly do these symptoms occur?
- How long do these symptoms last?
Vegetative anamnesis including nutritional anamnesis.
- Do you eat a balanced diet?
- Do you consume many foods high in vasoactive or psychoactive biogenic amines (flavor and taste compounds naturally occurring in foods)? Biogenic amines include, for example:
- Histamine – especially in cheese, red wine, fish, smoked meat products, sauerkraut, spinach and tomatoes.
- Cadaverine – contained mainly in cereal sprouts and sauerkraut.
- Feruloylputrescine – in grapefruit
- Putrescine* – especially in cereal sprouts and sauerkraut; Maggi, raw sausage.
- Serotonin – mainly contained in walnuts, pineapple, bananas and tomatoes.
- Spermidine – in cereal sprouts.
- Spermine – in cereal seedlings
- Synephrine – found in tangerines and oranges.
- Tyramine* – found especially in yeast, fish, sausage, cheese, raspberries, sauerkraut, Maggi.
- Do you consume many foods that contain food additives* ?
- Antioxidants (e.g., butylated hydroxyanisole (BHA)/E320, butylated hydroxytoluene (BHT)/E321, gallates/E310 – E312).
- Flavorings
- Colorants or azo dyes (e.g. amaranth/E123, quinoline yellow/E104, cochineal red, erythrosine/E 127, yellow orange S/E127, indigotine (indigcarmine)/E132, curcumin/E100, patent blue/E131, tartrazine/E102, etc.; see under food additives/dyes).
- Gelling agents (e.g. mannitol/E421, sorbitol/E420/).
- Flavor enhancers (glutamic acid and its salts (glutamates)/E620-625).
- Preservatives (benzoates – p-hydroxybenzoic acid: benzoic acid and its salts/E210; metasulfites, nitrites and nitrates/E49 – E252, PHB esters/E214 – E219, propionic acid, sulfur dioxide and sulfites/E 221 – E227, sorbic acid and its salts/E200).
- Acidity regulators (e.g. tartrate/E337).
- Stabilizers or gelling agents (eg sorbitol/E420/, mannitol/E421).
- Salicylates (salicylic acid)
- How are your bowel movements (diarrhea/constipation)?
Self history including medication history.
- Pre-existing conditions
- Operations
- Allergies
- Medication history
Medication history
Medication groups*
- Analgesics (pain relievers; such as ASA (acetylsalicylic acid)).
- Intravenous anesthetics – drugs used for induction and management of anesthesia.
- Colloidal plasma substitutes (infusion solutions).
- Local anesthetics – drugs used for regional anesthesia such as lidocaine.
- Muscle relaxants – drugs such as Mivacurium, which are used to relax muscles and during anesthesia.
- X-ray contrast media
Drugs that are inhibitors of DAO (diamine oxidase).
- Ambroxol
- Aminoglycosides (framycetin, neomycin, paromomycin).
- Aminophylline
- Amitriptyline
- Chloroquine
- Clavulanic acid
- Dihydralazine
- Gelatin (plasma expander)
- Metoclopramide
- N-acetylcysteine
- Isoniazid
- Metoclopramide
- Pentamidine
- Pirenzepine
- Promethazine
- Verapamil
Non-steroidal analgesics or anti-inflammatory drugs listed below may additionally lead to histamine release in individuals with allergic disposition, so there may be an increased histamine effect:
- Acetylsalicylic acid
- Diclofenac
- Indometacin
- Flurbiprofen
- Ketoprofen
- Meclofenamic acid
- Mefenamic acid
- Naproxen
* Patients with pseudoallergies often also react to components (e.g., dyes) of drugs: the azo dye tartrazine (E 102) and yellow orange S (E 110) is often added to various drugs, including anti-allergy drugsOther dyes in drugs with allergy risk are: Quinoline Yellow (E 104), True Yellow (E 105) and Ponceau 4R (E 124)! (Note: this list is only exemplary!) Under “Food additives” you will find a database with all substance groups: Food additives with allergic and/or pseudoallergic potential are marked accordingly. Note!When searching for the trigger of a pseudoallergy, keeping a food diary is helpful.
