Pseudo-Allergen-Free Diet in Chronic Urticaria

Verschave, A.; Stevens, Erik; Degreef, Hugo

doi:10.1159/000249792

Cited by 22 publications

(5 citation statements)

References 7 publications

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“…The value of an additive-free diet has been questioned as a treatment modality for chronic urticaria [11,12], however, several authors have found it beneficial [1][2][3][4][5][6][7][8][9][10]. The estimation of the effect of diet is difficult because of the capricious nature of the disease and possible differences in the usage of antihistamines.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic and recurrent urticaria and recurrent angioedema are common dermatological problems, and several authors have reported alleviation of symptoms during an additive-free diet [1][2][3][4][5][6][7][8][9][10], although in other reports the role of food additives has been questioned [11,12]. Oral provocation tests (OPT) with various food additives have been used to establish the causative or exacerbating agents [1][2][3][4][6][7][8][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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The results of skin testing with food additives and the effect of an elimination diet in chronic and recurrent urticaria and recurrent angioedema

Malanin

Kalimo

1989

Clin Experimental Allergy

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Ninety-one subjects suffering from chronic or recurrent urticaria or recurrent angioedema of 2 months to 17 yr duration were skin-prick and scratch tested with 18 various food additives. Twenty-four of the subjects (26%) had at least one histamine equivalent skin test (ST) reaction. In contrast, only 24 (10%) of 247 non-urticaria control subjects showed comparable results. An oral provocation test with food additives was carried out on 10 of the 24 ST-positive subjects with urticaria or angioedema, but only one positive reaction, caused by benzoic acid, was recorded. All 91 subjects were advised to follow an additive-free diet. The effect of the diet was investigated with a retrospective postal survey. Twenty-three ST-positive subjects returned the questionnaire, 18 had followed the diet, and 16 (89%) of these 18 had experienced marked relief of their symptoms. Correspondingly, 42 of the 47 ST-negative subjects had followed the diet, and 17 (40%) had improved. The difference was significant (P less than 0.05). Our results suggest that skin tests with food additives can be used to measure skin hyperreactivity and that they may have a predictive value in identifying patients who will respond to an additive-free diet.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The results of skin testing with food additives and the effect of an elimination diet in chronic and recurrent urticaria and recurrent angioedema

Malanin

Kalimo

1989

Clin Experimental Allergy

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“…Acute urticaria is much more likely to be caused by food allergy than CU. However, there is a subgroup of patients with RCIU with food-additive-evoked urticaria [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22]. …”

Section: Introductionmentioning

confidence: 99%

Food-Additive-Induced Urticaria: A Survey of 838 Patients with Recurrent Chronic Idiopathic Urticaria

Lorenzo

Pacor

Mansueto

et al. 2005

Int Arch Allergy Immunol

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Background: Recurrent chronic idiopathic urticaria (RCIU) is a common skin condition that affects 0.1–3% of the population in the USA and Europe and accounts for nearly 75% of all ‘ordinary’ chronic urticaria (CU) cases. Methods: We studied 838 consecutive patients with RCIU referred to hospital between 1998 and 2003. Patients with known causes of CU were excluded. Clinical history, physical examination, and symptom diaries were evaluated during two periods, a diet-free period (1 week) and a food-additive-free diet (FAFD) period (4 weeks), respectively, and two double-blind placebo-controlled (DBPC) challenges of six food additives were administered. The first DBPC challenge included a mixture of the six food additives (DBPC_mixed) given to all patients. The second DBPC challenge comprised the single food additives, administered at increasing doses (DBPC_single) to patients with a positive DBPC_mixed test and 105 patients with a negative DBPC_mixed test, as a control. Results: The DBPC_mixed challenge was positive in 116 patients. None of the 105 control patients had a positive DBPC_single test. Only 31 DBPC_single tests were positive in patients with positive DBPC_mixed challenge. Twenty-four of the 116 patients showing a positive DBPC_mixed challenge also had a positive DBPC_single result. Conclusions: Our results confirmed that food additive hypersensitivity reactions occurred in few RCIU patients using DBPC_single challenge. The combination of the results of FAFD and DBPC_mixed challenge seems to be of considerable practical interest for allergists, internists and dermatologists, rather than the data of clinical history and the results of DBPC_single challenge, in patients with RCIU.

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“…Dietary restrictions have been widely used as a diagnostic and therapeutic tool in chronic and recurrent urticaria. Good or excellent results have been reported in 31-81 % of the patients in these experiments (50,72,87,94,119,147,149). August (7) successfully treated 22 urticaria patients, sensitive to tartrazine and sodium benzoate, with disodium cromoglycate (DSCG) and an exclusion diet.…”

Section: Avoidance Dietsmentioning

confidence: 97%

Hypersensitivity reactions to food additives

Hannuksela

Haahtela

1987

Allergy

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Only seldom have food additives been shown to cause true allergic (immunologicjil) reactions. Adverse effects due to various pharmacological or other mechanisms are much more common. The individual tolerance may be decreased for one reason or another, and may fluctuate from time to time. Many patients suffering from food additive reactions have atopic constitutions and such clinical symptoms as fiexural dermatitis, rhinitis and asthma. The most important skin symptoms caused by food additives are urticaria, angioneurotic edema, and contact urticaria. Azo dyes, benzoic acid and several other common food additives may aggravate or, more rarely, even cause urticaria. Spices are one of the most common causes of immunological contact urticaria. Non-immunological contact urticaria is produced by numerous spices, benzoic acid, sorbic acid, cinnamic acid, and many essential oOs. Asthma and rhinitis are the main hypersensitivity symptoms in the respiratory tract, and azo dyes, benzoic acid, and sulfitic food additives are the most common causative agents. Systemic and respiratory reactions to food colorants and benzoates have been claimed to occur more frequently in acetylsalicylic acid-(ASA-)sensitive patients than in non-reactors. Hypersensitivity reactions in organs other than the skin and respiratory tract are rare or poorly documented. Psychological factors play an essential role in both food and food additive reactions.

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Pseudo-Allergen-Free Diet in Chronic Urticaria

Abstract: An elimination diet for additives and tyramine was prescribed to 67 patients with chronic urticaria. 55% of them reacted favorably. Success of dietary treatment was associated with atopy and normal levels of biochemical markers of inflammation.

Cited by 22 publications

References 7 publications

The results of skin testing with food additives and the effect of an elimination diet in chronic and recurrent urticaria and recurrent angioedema

The results of skin testing with food additives and the effect of an elimination diet in chronic and recurrent urticaria and recurrent angioedema

Food-Additive-Induced Urticaria: A Survey of 838 Patients with Recurrent Chronic Idiopathic Urticaria

Hypersensitivity reactions to food additives

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