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Guideline on management of suspected adverse reactions to ingested histamine - Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergology and Environmental Medicine (GPA), the Medical Association

Imke Reese, Barbara Ballmer-Weber, Kirsten Beyer, Sabine Dölle-Bierke, Jörg Kleine-Tebbe, Ludger Klimek, Sonja Lämmel, Ute Lepp, Joachim Saloga, Christiane Schäfer, Zsolt Szepfalusi, Regina Treudler, Thomas Werfel, Torsten Zuberbier, and Margitta Worm

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Volume 5 (2021) p. 305 - 314

Abstract

Allergologie select, Vol. 5/2021 (305-314)

Imke Reese¹, Barbara Ballmer-Weber², Kirsten Beyer³, Sabine Dölle-Bierke⁴, Jörg Kleine-Tebbe⁵, Ludger Klimek⁶, Sonja Lämmel⁷, Ute Lepp⁸, Joachim Saloga⁹, Christiane Schäfer¹⁰, Zsolt Szepfalusi¹¹, Regina Treudler¹², Thomas Werfel¹³, Torsten Zuberbier¹⁴, and Margitta Worm⁴

¹Nutrition Therapy, Munich, Germany, ²Clinic for Dermatology and Allergology, Cantonal Hospital St. Gallen and Department of Dermatology, University Hospital Zurich, Switzerland, ³Clinic for Pediatrics with focus on Pneumology and Immunology, Charité-Universitätsmedizin – Campus Virchow-Klinikum, Berlin, ⁴Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, ⁵Allergy and Asthma Center Westend, Berlin, ⁶Center for Rhinology and Allergology, Wiesbaden, ⁷German Allergy and Asthma Association (DAAB), Mönchengladbach, ⁸Practice for Pulmonary Medicine and Allergology, Stade, ⁹Department of Dermatology, University Medical Center, Johannes Gutenberg University, Mainz, ¹⁰Nutrition Therapy, Schwarzenbek, ¹¹Department of Pediatrics, Division of Pediatric Pulmonology, Allergology and Endocrinology, Comprehensive Center Pediatrics, Medical University of Vienna, Vienna, Austria, ¹²Department of Dermatology, Venereology and Allergology, Leipzig University Medical Center, ¹³Department of Dermatology and Allergy, Hannover Medical School, and ¹⁴Comprehensive Allergy Centre Charité, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Germany
Adverse reactions to food or food ingredients are more often perceived than objectively verifiable. However, reliable laboratory tests are often lacking. As a result, people with perceived adverse reactions to food often follow extensive elimination diets for years and unnecessarily restrict their diet, as in the case of the frequently suspected histamine intolerance. In this condition, laboratory parameters such as the determination of diamine oxidase in serum have been shown to be inconclusive. The lack of symptom reproducibility calls into question the clinical picture of adverse reactions to ingested histamine. In order to approach persons with perceived histamine intolerance and to support them in moving from blanket restrictions, which are often unnecessarily strict, to effective personalized therapeutic strategies, the present guideline of the Working Group on Food Allergy of the German Society of Allergology and Clinical Immunology (DGAKI) in cooperation with the Medical Association of German Allergists (AeDA), the Pediatric Allergology and Environmental Medicine (GPA) as well as the Swiss Society of Allergology and Immunology (SGAI) and the Austrian Society of Allergology and Immunology (ÖGAI) recommends a practicable diagnostic and therapeutic approach.Correspondence to:
Dr. Imke Reese, Ernährungsberatung und -therapie, Schwerpunkt Allergologie, Ansprengerstr. 19, 80803 München
Email: [email protected]

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