Pseudoallergy: Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Food intolerances due to enzymatic intolerance – intolerance due to pathophysiologic disorder such as enzyme deficiency (fructokinase, lactase) [carbohydrate malabsorption].
  • Food allergy
  • Bacterial overgrowth of the small intestine (if necessary, H2 breath test for glucose); the small intestine abkterielle overgrowth (as a cause of food intolerance) should be excluded with positive H2 breath test for fructose, lactose, sorbitol (if necessary, also lactulose)!

Mouth, esophagus (esophagus), stomach and intestine (K00-K67; K90-K93).

Associated diseases in food intolerances are:

  • Infections (such as lambliasis, chronic infections, or bacterial overgrowth/dysbiosis).
  • Mastocytosis – two main forms: cutaneous mastocytosis (skin mastocytosis) and systemic mastocytosis (whole body mastocytosis); clinical picture of cutaneous mastocytosis: Yellowish-brown spots of varying size (urticaria pigmentosa); in systemic mastocytosis, there are also episodic gastrointestinal complaints (gastrointestinal complaints), (nausea (nausea), burning abdominal pain and diarrhea (diarrhea)), ulcer disease, and gastrointestinal bleeding (gastrointestinal bleeding) and malabsorption (disorder of food absorption); In systemic mastocytosis, there is an accumulation of mast cells (cell type that is involved in, among other things, allergic reactions). Among other things, involved in allergic reactions) in the bone marrow, where they are formed, as well as accumulation in the skin, bones, liver, spleen and gastrointestinal tract (GIT; gastrointestinal tract); mastocytosis is not curable; course usually benign (benign) and life expectancy normal; extremely rare degeneration mast cells (= mast cell leukemia (blood cancer)).
  • Eosinophilic esophago-gastritis