[Food allergy? Intolerance? – Examination of adverse reactions to foods in 406 adult patients].

Introduction: The prevalence of adverse food reactions is increasing, with 10-20% of the adult population experiencing such complaints. Most symptoms are thought to be indicators of food allergy, although non-immune-mediated food intolerance and other (e.g., gastroenterological) disorders are more likely to cause them.

Aim: Our aim was to gain a better understanding of the adult patient group that has adverse food reactions and to discover the real background of the symptoms that are believed to be caused by food allergy. In addition, in the context of interdisciplinarity, we would like to emphasize the importance of differential diagnosis and collaboration with associate specialists.

Method: 406 adult (>18) patients underwent an allergo-dermatological examination in order to assess, identify, and isolate symptoms related to food. Patients were presented with various symptoms, all of which were identified as a sign of 'food allergy'. After a thorough medical history and examination, specific IgE tests were performed if deemed necessary. Patients were referred to other specialists if further examinations were needed to complete the examination.

Results: 307 (75.6%) women and 99 (24.4%) men were examined. The average age was 43.6 years. The most common dermatological diagnosis was urticaria (44.1%). Relevant IgE-mediated food allergy was detected in 6 of 406 patients (1.5%). Oral allergy syndrome was diagnosed in 35 cases (8.6%). In many cases, biogenic amine intolerance (50.2%) and other comorbidities (gastroenterological: 62.1%, chronic inflammation: 22.2%) were found as provocative factors. In the background of the symptoms, side effects of drugs taken by patients during meals were identified in 20 cases.

Conclusion: According to our data, biogenic amine intolerance is very common in the background of patients' food-related reactions, but the number of food allergies is overestimated. It is important for both healthcare professionals and patients to emphasize the diverse pathology behind adverse food reactions. Differentiation should always be based on thorough medical history, examination, and personalized management. Orv Hetil. 2020; 161(25): 1042-1049.