Pseudoallergy

The pseudo-allergy (synonym: pseudo-allergic reaction ) denotes an incompatibility reaction in their clinical symptoms very much a classic allergic reaction ( " immediate type " ) is similar, but without an immunological reaction would be detectable. The most common triggers are drugs and food additives.

Pathophysiology

The allergy-like symptoms can be triggered either because mast cells are non-specifically activated or because histamine due to an enzyme deficiency can not be broken ( Histamine Intolerance ).

Non-specific activation of mast cells

When mast cells are activated and degranulate, they set a number of inflammatory mediators. The result is an inflammatory response that manifests itself in allergy-like symptoms. While allergies activation of mast cells is specific, namely the fact that certain allergens can bind to surface-bound antibodies, the mast cell activation occurs in non-specific pseudo-allergies, ie without the involvement of surface-bound antibodies.

A number of substances are capable of activating mast cells specific:

  • Certain drugs such as unwanted side effect (see also intolerance (medicine) ) radiological contrast agent
  • Called nonsteroidal anti-inflammatory drugs ( NSAIDs) such as acetylsalicylic acid ( ASA), then as a NSAID intolerance, aspirin intolerance syndrome, AERD (Aspirin ® - exacerbated respiratory disease), prostaglandin synthesis inhibitors intolerance or analgesic asthma syndrome
  • Opiate
  • Certain muscle relaxants
  • Pentamidine
  • The dextran used in plasma expanders
  • Certain substances contained in food (you then also speaks of a food intolerance ): Lectins, for example, strawberries
  • Salicylates, such as apples, apricots, or
  • Some preservatives, such as benzoic acid or sorbic acid
  • Some acidifier

Diseases

Pseudoallergies have allergy-like symptoms, such as:

  • Swelling, redness and itching of the mucous membranes in the mouth and throat
  • Rhinitis
  • Symptoms in the gastrointestinal tract ( gastrointestinal symptoms )
  • Urticaria
  • Angioedema
  • Circulatory reactions

Characteristic of pseudo-allergies, a dose -response curve, which can not be observed in allergy. Thus, small amounts of histamine- releasing substances or histaminhaltiger foods can be tolerated without causing symptoms. As the amount of histamine -releasing substances or ingested histamine the severity of symptoms increases.

Because the pseudo-allergies are non- immunological reactions are thus not mediated via specific antibodies, they can occur on first contact with histamine -releasing substances or strong histamine- containing foods. A diagnosis of pseudo-allergies can not be done on the measurement of antibodies in blood samples therefore.

As it is undisputed is a possible connection with all of these diseases, so unclear is the extent to which food ingredients are to blame for these problems. To vary the details of the urticaria of less than 1 to about 50 percent.

Also remains unclear whether the complaints are occurring more frequently in atopic eczema in certain diet are a result of allergic or pseudo- allergic reactions to food ingredients and it therefore concerns a food allergy or a food intolerance. Also, why are ( DGAKI ) uniform rules for the holding of the work-up of suspected triggers, such as in food demanded by the German Society for Allergology and Clinical Immunology.

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