Histamine intolerance as a cause of chronic digestive complaints in pediatric patients

Rosell-Camps, Antonio; Zibetti, Sara; Perez-Esteban, Gerardo; Vila-Vidal, Magdalena; Ferrés-Ramis, L.; García-Teresa-García, Elisa

doi:10.4321/s1130-01082013000400004

Cited by 41 publications

(68 citation statements)

References 13 publications

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“…According to the literature [8, 13], in individuals with serum DAO activity < 3 U/mL, HI intolerance was expected, while in patients with serum DAO levels between 3 and 10 U/mL, HI was considered possible. Patients with DAO levels < 10 U/mL were identified with HI only if they showed two or more GI symptoms of HI (e.g., nausea, vomiting, meteorism, and/or abdominal pain) and a positive response to a low histamine diet [8, 13]. …”

Section: Methodsmentioning

confidence: 99%

Concomitant Prevalence of Low Serum Diamine Oxidase Activity and Carbohydrate Malabsorption

Enko

Meinitzer

Mangge

et al. 2016

Canadian Journal of Gastroenterology and Hepatology

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The aim of this retrospective study was to analyze the concomitant prevalence rates for lactose malabsorption (LM), fructose malabsorption (FM), and histamine intolerance (HI) in patients with so far unexplained gastrointestinal (GI) symptoms. A total of 439 outpatients, who presented unclear abdominal discomfort, underwent lactose (50 g) and fructose (25 g) hydrogen (H2) breath tests. Additionally, serum diamine oxidase (DAO) measurements were performed. Individuals with low serum DAO activity (<10 U/mL), GI symptoms, and response to histamine-free diet were diagnosed with HI. Of all 439 patients, 341 (77.7%) were found with 7 various GI conditions. In total, 94 (21.4%), 31 (7.1%), and 100 (22.8%) individuals presented LM, FM, or HI only, whereas 116 (26.4%) patients showed an overlap of GI entities investigated here. Interestingly, 89 out of 241 (36.9%) individuals with carbohydrate malabsorption were also diagnosed with HI (LM + HI: 52 [11.8%], FM + HI: 23 [5.2%], and LM + FM + HI 14 [3.2%] individuals). In conclusion different combinations of LM, FM, and HI are present in individuals with unclear abdominal discomfort/pain. In clinical practice we suggest testing for LM, FM, and additional HI in the diagnostic work-up of these patients. Depending on these various diagnoses possible, patients should get an individualized dietary advice.

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Section: Methodsmentioning

confidence: 99%

Concomitant Prevalence of Low Serum Diamine Oxidase Activity and Carbohydrate Malabsorption

Enko

Meinitzer

Mangge

et al. 2016

Canadian Journal of Gastroenterology and Hepatology

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“…Histamine intolerance has already been reported as a causal trigger for cardinal gastrointestinal disorders like abdominal pain, diarrhoea and flatulence 2, 15, 16. On the one hand, the patients' clinical presentation can resemble other food intolerances or allergy and is usually diagnosed under the umbrella of irritable bowel syndrome (IBS) 2, 7.…”

Section: Introductionmentioning

confidence: 99%

“…On the one hand, the patients' clinical presentation can resemble other food intolerances or allergy and is usually diagnosed under the umbrella of irritable bowel syndrome (IBS) 2, 7. On the other hand, histamine intolerance is also characterized by extra‐intestinal symptoms such as headache,15 pruritus,16 urticaria,17 atopic eczema,18 cardiac arrhythmia19 and asthma13, 14 that exceed the diagnosis of IBS. As both the aetiology and the course of histamine intolerance are not sufficiently investigated, the knowledge and treatment in the medical field are not always uniform.…”

Section: Introductionmentioning

confidence: 99%

Circadian profiling reveals higher histamine plasma levels and lower diamine oxidase serum activities in 24% of patients with suspected histamine intolerance compared to food allergy and controls

Pinzer

Tietz

Waldmann

et al. 2017

Allergy

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BackgroundHistamine intolerance is thought to trigger manifold clinical symptoms after ingesting histamine‐rich food due to reduced activity of diamine oxidase (DAO). No study has hitherto systematically assessed daily fluctuations of histamine levels and DAO activities in symptomatic patients. The aim of the study was to investigate the presence of histamine intolerance, to therefore establish day profiles of histamine levels and DAO activities, and to compare the results between patients with suspected histamine intolerance, food allergy and healthy controls.MethodsWe determined day profiles of histamine plasma levels and DAO serum activities in 33 patients with suspected histamine intolerance, in 21 patients with proven food allergy and in 10 healthy control patients. Clinical symptoms, food intolerances and further clinical and laboratory chemical parameters were evaluated.ResultsTwenty‐four percent (8 of 33) suspected histamine‐intolerant patients showed elevated histamine levels during the day. That might be caused by constantly and significantly reduced DAO activities in these patients compared to food‐allergic and control patients. The remaining 25 patients presented normal histamine levels and DAO activities, but an increased prevalence of multiple food intolerances compared to the other subgroup of suspected histamine‐intolerants. There was no correlation between subjective complaints and serological histamine parameters in patients with suspected histamine intolerance.ConclusionsWe determined by daily profiling that decreased DAO activities correlated with elevated histamine levels in a subgroup of suspected histamine‐intolerants. This finding discriminates these patients from food intolerant individuals with similar clinical symptoms and strongly suggests the presence of histamine intolerance.

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“…In addition, certain drugs, such as aspirin, nonsteroidal anti-inflammatory drugs, some antidepressants, tuberculostatics, or alcoholic beverages diminish histamine catabolism due to a chemical blocking of DAO [108]. The most frequent symptoms reported in HI include abdominal pain, diarrhea, pruritis, flushing, rhinorrhea, and headache [109]. The prevalence of HI is about 1% of the population, and it is typically present more often in middle-aged sensitive individuals, particularly in women [107].…”

Section: Allergy-like Reactions To Seafood: Histamine Fish Poisoning mentioning

confidence: 98%

“…After seafood allergies and HFP have been ruled out, management of HI includes plasma DAO measurement and low-histamine diet (fresh white fish such as hake). Generally, management with a histamine-restricted diet provides immediate improvement of histamine intolerance [109]. However, the approach to reduce dietary sources of histamine needs to be individualized, ensuring that the patient's diet remains adequate in all nutrients [111].…”

Section: Diagnosis and Treatment Of Hfp And Himentioning

confidence: 99%

Seafood Allergy, Toxicity, and Intolerance: A Review

Prester

2015

Journal of the American College of Nutrition

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Seafood allergies have been increasing their presence in the last 2 decades. Allergic reactions to seafood can range from mild urticarial and oral allergy syndrome to life-threatening anaphylactic reactions. Ingestion of seafood infested with Anisakis larvae can cause a disease known as anisakiasis with symptoms similar to true seafood allergy. Furthermore, some adverse reactions to seafood including histamine fish poisoning (HFP), and intolerance to histamine can trigger clinical symptoms, which, although nonallergic in origin, are similar to true immunoglobulin E (IgE)-mediated allergic reactions. Because seafood allergy usually remains a lifelong food allergy, this review focuses on the current knowledge on fish and shellfish allergens and emphasizes the importance of differentiating seafood allergy from other allergy-like reactions (anisakiasis, HFP, and intolerance to histamine). Key teaching points: • Fish and shellfish are potent allergens that can provoke serious IgE antibody-mediated adverse reactions in sensitive individuals. • Sensitization to seafood allergens can be achieved by ingestion, inhalation, or skin contact. • Shellfish major allergen, tropomyosin, shares significant homology to arthropods (dust mites and cockroaches). • Accidental exposures to seafood products cross-contaminated with fish or shellfish allergens (hidden allergens) during processing may present a health risk for sensitive individuals. • Allergens of fish parasite A. simplex present common hidden allergens in seafood, particularly in raw and undercooked home-made fish dishes. • Symptoms caused by HFP, histamine intolerance, and anisakiasis are similar to true seafood allergy.

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Histamine intolerance as a cause of chronic digestive complaints in pediatric patients

Cited by 41 publications

References 13 publications

Concomitant Prevalence of Low Serum Diamine Oxidase Activity and Carbohydrate Malabsorption

Concomitant Prevalence of Low Serum Diamine Oxidase Activity and Carbohydrate Malabsorption

Circadian profiling reveals higher histamine plasma levels and lower diamine oxidase serum activities in 24% of patients with suspected histamine intolerance compared to food allergy and controls

Seafood Allergy, Toxicity, and Intolerance: A Review

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