Nahrungsmittelallergien

Abstract

Adverse reactions to food must be clearly defined on the basis of pathogenetic mechanisms according to the position paper of the Subcommittee on Adverse Reactions to Food of the European Academy of Allergology and Clinical Immunology. For immune-mediated reactions, the term 'food allergy' is recommended, while non-immune-mediated reactions are referred as 'food intolerance'. IgE-mediated allergies can be recognized by means of a careful history and allergological examination, using prick-, prick-to-prick-, intracutaneous-, scratch- or rub tests with food allergen extracts or fresh foods, and specific determinations by different serological methods (RAST, CAP). Immunological cross-reactions between fruits, vegetables, spices and pollen-sensitization become more and more frequent, especially to birch and mugwort pollens (birch-mugwort-celery-carrot-spice-syndrome) as well as the latex-fruit-syndrome. The clinical evaluation of positive skin or serological tests must be performed by means of double-blind, placebo-controlled food challenges (DBPCFC), with the exclusion of patients who reported severe anaphylactic reactions. An elimination diet should be conducted under supervision of an experienced dietetician.