Article

Histamine intolerance in children with chronic abdominal pain

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Abstract

The term histamine intolerance (HIT) describes a proposed disease in which patients develop a variety of symptoms following the ingestion of foods rich in histamine.1 ,2 Due to an assumed reduced activity of intestinal diamine oxidase (DAO), histamine-rich foods (eg, aged cheese, cured meat or sausages, fish) cause above-normal serum histamine levels.3 These elevated histamine levels cause various histamine receptor–mediated symptoms such as flush, headache or urticaria, and with respect to the gastrointestinal tract, diarrhoea and abdominal pain. In adults, measuring low DAO levels (<10 U/mL) in combination with improvement to a histamine-free diet has been suggested to be diagnostic for HIT.1 Chronic abdominal pain is a common problem in paediatric gastroenterology. In children, there is no study that addresses the question if HIT can be identified as the cause for chronic abdominal pain. Within 26 months, 394 children presented with chronic abdominal …

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... In one study involving children, about 8% of children who report chronic abdominal pain and have a history of histamine-rich foods consumption had decreased serum DAO concentrations [42]. Males seem to predominate in the paediatric population which is different from the adult population [7,42,43]. ...
... In one study involving children, about 8% of children who report chronic abdominal pain and have a history of histamine-rich foods consumption had decreased serum DAO concentrations [42]. Males seem to predominate in the paediatric population which is different from the adult population [7,42,43]. However, all these hypotheses need to be verified in larger cohorts. ...
... As of now, two publications proposing a diagnostic scheme for paediatric HIT are available. Hoffman et al. propose the following diagnostic criteria: (1) patient has chronic abdominal pain; (2) patient has serum DAO concentration ≤10 IU/mL; (3) the suspected HIT symptoms improve after histamine-reduced diet; (4) positive result of histamine provocation test [42]. ...
Article
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Histamine intolerance is defined as a disequilibrium of accumulated histamine and the capacity for histamine degradation. This clinical term addresses a non-immunologically mediated pathology when histamine ingested with food is not particularly high, however its degradation is decreased. This paper aims to provide a narrative review on etiopathology, epidemiology, possible diagnostic algorithms and diagnostic challenges of histamine intolerance in children. The clinical picture of histamine intolerance in children is similar to that observed in adults apart from male predominance found in paediatric patients. Both in children and adults, a histamine-reduced diet is typically the treatment of choice. Diamine oxidase supplementation offers another treatment option. There is no symptom or test pathognomonic for histamine intolerance. Nevertheless, manifestations of chronic gastrointestinal symptoms, measurements of diamine oxidase deficits, positive results of histamine provocation tests and improvement in symptoms with histamine-reduced diet considerably increase the probability of histamine intolerance diagnosis. These factors have been included in the proposed diagnostic algorithm for histamine intolerance. In children histamine intolerance most likely co-occurs with allergies and bowel diseases, which creates an additional diagnostic challenge. As the evidence for children is poor further research is needed the determine epidemiology, validate diagnostic algorithms and establish possible treatment options regarding histamine intolerance.
... In one study involving children, about 8% of children who report chronic abdominal pain and have a history of histamine-rich foods consumption have decreased serum DAO concentration [30]. Also, males seem to predominate in the paediatric population which is different to the adult population [5,30,31]. ...
... In one study involving children, about 8% of children who report chronic abdominal pain and have a history of histamine-rich foods consumption have decreased serum DAO concentration [30]. Also, males seem to predominate in the paediatric population which is different to the adult population [5,30,31]. However, all these hypotheses need to be verified in larger cohorts. ...
... As of now, two publications proposing a diagnostic scheme for paediatric HIT are available. Hoffman et al. propose the following diagnostic criteria: 1) patient has chronic abdominal pain; 2) patient has serum DAO concentration ≤10 IU/mL; 3) the suspected HIT symptoms improve after histamine-free diet; 4) positive result of histamine provocation test [30]. ...
Preprint
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Histamine intolerance is defined as disequilibrium of accumulated histamine and the capacity for histamine degradation. This clinical term addresses a non-immunologically mediated pathology when histamine ingested with food is not particularly high, but its degradation is decreased. Clinical picture of histamine intolerance in children is similar to that observed in adults apart from male predominance found in paediatric patients. Both in children and adults, histamine-free diet seems to be the treatment of choice. Diamine oxidase supplementation offers another treatment option. There is no symptom and\or test pathognomonic for histamine intolerance. Nevertheless, manifestations of chronic gastrointestinal symptoms, measurement of diamine oxidase deficits, positive results of histamine provocation tests and improvement of symptoms with histamine-free diet greatly increase the probability of histamine intolerance diagnosis. These factors have been included in the proposed in this paper diagnostic algorithm for histamine intolerance. In children histamine intolerance probably co-occur with allergies and bowel diseases, which creates an additional diagnostic challenge. As the evidence for children is weak, further research is needed the establish epidemiology, validate diagnostic algorithms and establish possible treatment options regarding histamine intolerance.
... Endogenous and exogenous environmental factors, health status. Habitat peculiarities and lifestyle of individuals also have a modifying effect on the functioning of the histamine metabolic network [5,29,58,85,109,110]. Thus, it was demonstrated that DAO (AOC1) deficiency is common in patients with migraine, but a low level of this enzyme was also registered in healthy individuals (in 87 and 44% of individuals, respectively) [103], which indicates the presence of other factors contributing to the manifestation of adverse effects of alleles. ...
... In another study, evidence that DAO (AOC1) activity can depend on variants of the gene encoding this enzyme are given [58], but the authors concluded not only unfavorable allelic variants but also the effect of additional (ecological) factors is required for the manifestation of pathological symptoms in histamine intolerance. Indeed, it was established that, if patients with histamine intolerance followed a diet with a low level of this amine, not only symptoms of the disease decreased in them, but also the activity of the AOC1 enzyme increased [5,85]. ...
... It is also known that histamine is involved in the regulation of different signaling pathways [13,16,19]. At the same time, the formation of this amine and its release (in particular, from mast cells), as well as the expression and activation of histamine metabolism enzymes and its receptors, depend on a wide spectrum of not only exogenous [1,5,64,107,110,111] but also endogenous stimuli [112]. ...
Article
Histamine is a biologically active substance of local effect, but is involved in the regulation of different processes in the body, including the pathogenesis of diseases. In the present review, molecular genetic, clinical, and experimental studies on the role of histamine and key genes of its metabolism in the pathogenesis of diseases are summarized. Data on associated polymorphic variants (30 SNPs, 1 CNV) of key histamine metabolism genes with multifactorial diseases are given, including HDC (involved in the synthesis of histamine), HNMT, AOC1, MAOB, ALDH7A1 (involved in the processes of histamine degradation), and HRH1, HRH2, HRH3, HRH4 (histamine receptors): associations were established with allergic and oncological diseases, diseases of nervous and cardiovascular systems, gastrointestinal tract, metabolic disorders, etc. A nonrandomness of established associations of histamine metabolic pathway genes with pathological conditions is supported by clinical observations and experimental studies performed on model objects and cell lines. Moreover, according to clinical and experimental data, a wider range of pathological conditions in which risk structural and functional peculiarities of key histamine metabolic pathway genes will make a certain contribution can be expected. The questions of the complexity of determining the significance of histamine level and structural and functional peculiarities of histamine metabolic pathway genes in terms of a positive/negative effect on the body, as well as some possible reasons for inconsistency of association studies performed in different ethnoterritorial groups, are discussed.
... In this case, it was found that 71% of patients had serum DAO activity under the threshold considered as cut-off for histamine intolerance with a mean DAO activity value significantly lower than healthy controls. Apart from these studies dealing with patients with coexisting histamine intolerance symptoms, other clinical studies have correlated DAO deficiency with some specific pathologies, mainly gastrointestinal and dermatological complaints [6,8,9,16,21,23,25,26]. However, according to our knowledge, there is little information available about serum DAO levels in patients clinically diagnosed with migraine. ...
... Concretely, 88% of these paediatric patients showed DAO deficiency. More recently, in an observational study performed by Hoffmann et al. [8] in 394 children with chronic abdominal pain, only 8% showed DAO activity levels under the normal threshold. ...
... Moreover, these percentages are in good agreement with those described by Mušič et al. [22] and Manzotti et al. [19], which considered patients clinically suspected as histamine intolerants with diverse coexisting symptoms (Table 2). However, other studies addressing different specific pathologies, such as atopic eczema, chronic urticaria, lactose malabsorption and chronic abdominal pain, reported lower percentages of DAO deficit, with values ranging between 8 and 57% [2,6,8,16,28]. ...
Article
Background & aims: Histamine intolerance is a disorder in the homeostasis of histamine due to a reduced intestinal degradation of this amine, mainly caused by a deficiency in the enzyme diamine oxidase (DAO). Among histamine related symptoms, headache is one of the most recorded. Current clinical strategies for the treatment of the symptomatology related to this disorder are based on the exclusion of foods with histamine or other bioactive amines and/or exogenous DAO supplementation. The aim of this study was to assess the efficacy of a food supplement consisting of DAO enzyme as a preventive treatment of migraine in patients with DAO deficiency through a randomized double-blind trial. Methods: 100 patients with confirmed episodic migraine according to current International Headache Society (IHS) criteria and DAO deficiency (levels below 80 HDU/ml) were randomized in two groups. One group received DAO enzyme supplementation and the other received placebo for one month. Clinical outcomes assessed were duration and number of attacks, perception of pain intensity and adverse effects during treatment. The use of triptans was also recorded. Results: Great variability was found in the duration of migraine attacks reported by placebo and DAO groups. A significant reduction (p = 0.0217) in hours of pain was achieved in patients treated with DAO supplement, with mean durations of 6.14 (±3.06) and 4.76 (±2.68) hours before and after treatment, respectively. A smaller reduction without statistical signification was also observed for this outcome in the placebo group, from 7.53 (±4.24) to 6.68 (±4.42) hours. Only in DAO group, a decrease in the percentage of patients taking triptans was observed. The number of attacks and the scores of pain intensity showed a similar reduction in both groups. No adverse effects were registered in patients treated with DAO enzyme. Conclusions: Migrainous patients supplemented with DAO enzyme during one month significantly reduced the duration of their migraine attacks by 1.4 h. No statistically significant reduction was found in placebo group before and after treatment. The reduction of pain hours observed in placebo group (0.9 h) could explain the lack of significant differences between both study groups. One month of DAO supplementation has demonstrated a positive trend in the improvement of migraine but more studies with a longer treatment period are needed to better assess the efficacy of DAO supplementation. Clinical trial registration number: ISRCTN10091019; www.isrctn.org.
... In this case, it was found that 71% of patients had serum DAO activity under the threshold considered as cut-off for histamine intolerance with a mean DAO activity value significantly lower than healthy controls. Apart from these studies dealing with patients with coexisting histamine intolerance symptoms, other clinical studies have correlated DAO deficiency with some specific pathologies, mainly gastrointestinal and dermatological complaints [6,8,9,16,21,23,25,26]. However, according to our knowledge, there is little information available about serum DAO levels in patients clinically diagnosed with migraine. ...
... Concretely, 88% of these paediatric patients showed DAO deficiency. More recently, in an observational study performed by Hoffmann et al. [8] in 394 children with chronic abdominal pain, only 8% showed DAO activity levels under the normal threshold. ...
... Moreover, these percentages are in good agreement with those described by Mušič et al. [22] and Manzotti et al. [19], which considered patients clinically suspected as histamine intolerants with diverse coexisting symptoms (Table 2). However, other studies addressing different specific pathologies, such as atopic eczema, chronic urticaria, lactose malabsorption and chronic abdominal pain, reported lower percentages of DAO deficit, with values ranging between 8 and 57% [2,6,8,16,28]. ...
Article
Histamine intolerance is a disorder in the homeostasis of histamine due to a reduced intestinal degradation of this amine, mainly caused by a deficiency in the enzyme diamine oxidase (DAO). Among the several multi-faced symptoms associated with histamine intolerance, headache is one of the most recognized and disabling consequences. The aim of this study was to determine the prevalence of DAO deficiency in patients with a confirmed migraine diagnosis according to the current International Headache Society (IHS) and in non-migraine subjects. DAO activity was assessed in a total of 198 volunteers recruited at the Headache Unit of the Hospital General de Catalunya, 137 in the migraine group and 61 as a control group. DAO enzyme activity in blood samples was determined by ELISA test. Values below 80 HDU/ml (Histamine Degrading Unit/ml) were considered as DAO deficient. Mean value of DAO activity from migraine population (64.5 ± 33.5 HDU/ml) was significantly lower (p < 0.0001) than that obtained from healthy volunteers (91.9 ± 44.3 HDU/ml). DAO deficiency was more prevalent in migraine patients than in the control group. A high incidence rate of DAO deficiency (87%) was observed in the group of patients with migraine. On the other hand, 44% of non-migranous subjects had levels of DAO activity lower than 80 HDU/ml. Despite the multifactorial aetiology of migraine, these results seem to indicate that this enzymatic deficit could be related to the onset of migraine.
... They include gastrointestinal (abdominal pain, diarrhea, vomiting), dermatological (urticaria, dermatitis, or pruritus), respiratory (rhinitis, nasal congestion, and asthma), cardiovascular (hypotonia and arrhythmias), and neurological (headaches) symptoms, and it is common for more than one disorder to occur simultaneously [1,11,12]. Several clinical studies have shown that patients with a potential diagnosis of histamine intolerance or with a diagnosis of migraine, intestinal, or dermatological diseases (atopic dermatitis, eczema, or chronic urticaria) have a higher prevalence of DAO deficits compared to the control population [3,6,[18][19][20][21][22][23][24][25][26][27][28]. ...
... At present, the main strategy to prevent the onset of histamine intolerance symptoms is to follow a low-histamine diet. Its efficacy has been demonstrated in different clinical studies, which have always described an improvement or remission of gastrointestinal, dermatological, and neurological symptoms [3,6,[18][19][20]22,24,27,[65][66][67] if the diet was followed. ...
Article
Full-text available
Low-histamine diets are currently used to reduce symptoms of histamine intolerance, a disorder in histamine homeostasis that increases plasma levels, mainly due to reduced diamine-oxidase (DAO) activity. These diets exclude foods, many of them of plant origin, which patients associate with the onset of the symptomatology. This study aimed to review the existing data on histamine and other biogenic amine contents in nonfermented plant-origin foods, as well as on their origin and evolution during the storage or culinary process. The only plant-origin products with significant levels of histamine were eggplant, spinach, tomato, and avocado, each showing a great variability in content. Putrescine has been found in practically all plant-origin foods, probably due to its physiological origin. The high contents of putrescine in certain products could also be related to the triggering of the symptomatology by enzymatic competition with histamine. Additionally, high spermidine contents found in some foods should also be taken into account in these diets, because it can also be metabolized by DAO, albeit with a lower affinity. It is recommended to consume plant-origin foods that are boiled or are of maximum freshness to reduce biogenic amine intake.
... Although scientific studies on adverse reactions to ingested histamine have been carried out predominantly in adults to date, the diagnosis is also made in children and adolescents, often with significant consequences to the diets of affected individuals. Two reports on digestive disorders in children caused by histamine are now available [1,2]. A retrospective observational study conducted in Spain [1] discusses histamine as a possible trigger; however, since diagnosis was based on low diamine oxidase (DAO) levels and dietary modifications without follow-up challenge, this study was not in line with recommendations. ...
... A retrospective observational study conducted in Spain [1] discusses histamine as a possible trigger; however, since diagnosis was based on low diamine oxidase (DAO) levels and dietary modifications without follow-up challenge, this study was not in line with recommendations. A German study [2] concluded that, although 50% of patients with suspected histamine intolerance responded to dietary changes, double-blind, placebocontrolled provocation was able to prove only one case of histamine intolerance. This position paper by the "Food Allergy" Working Group of the German Society for Allergology and Clinical Immunology (DGAKI) in collaboration with the German Association of Allergologists (AeDA), the Society for Pediatric Allergology and Environmental Medicine (GPA), and the Swiss Society for Allergology and Immunology (SGAI) reviews the data on the clinical picture of adverse reactions to ingested histamine, summarizes important aspects and their consequences, and proposes a practical diagnostic and therapeutic approach. ...
Article
Full-text available
Adverse food reactions are far more often perceived than objectively verified. In our scientific knowledge on non-allergic adverse reactions including the so called histamine intolerance, there are large deficits. Due to the fact that this disorder is increasingly discussed in the media and the internet, more and more people suspect it to be the trigger of their symptoms. The scientific evidence to support the postulated link between ingestion of histamine and adverse reactions is limited, and a reliable laboratory test for objective diagnosis is lacking. This position paper by the “Food Allergy” Working Group of the German Society for Allergology and Clinical Immunology (DGAKI) in collaboration with the German Association of Allergologists (AeDA), the Society for Pediatric Allergology and Environmental Medicine (GPA), and the Swiss Society for Allergology and Immunology (SGAI) reviews the data on the clinical picture of adverse reactions to ingested histamine, summarizes important aspects and their consequences, and proposes a practical diagnostic and therapeutic approach.
... or beverages, consumption of foods or other substances that cause histamine to be released, or an impaired ability for enzymes (ie, diamine oxidase [DAO] and histamine N-methyl transferase [HNMT]) in the body to break it down. [2][3][4][5][6][7][8] After food allergies have been ruled out, a low-histamine diet is often recommended, and a favorable response to it can help aid in the diagnosis of a histamine intolerance. 2,3,5-7 Because exposure to histamine exists beyond diet, total avoidance of histamines is not attainable. ...
... [2][3][4][5]7 Dietary sources that are high in histamine include many aged and fermented foods and beverages (eg, cheeses, yogurt, processed meats, alcoholic beverages, sauerkraut, soy 2-8 ); some fish, especially frozen, smoked, and canned varieties; fruits, such as strawberries and cherries; vegetables, including spinach, tomatoes, and eggplant; and seasonings, such as chili powder, cinnamon, cloves, and vinegar. [2][3][4][5][6][7][8] The list is not exhaustive, and the amount of histamine from dietary sources can vary. 5,7 Foods that are minimally processed are encouraged, since even the removal of skins or peels on produce can increase their histamine content. ...
... For a long time, the condition was postulated to affect only adults and, in particular, patients with chronic spontaneous urticaria and other skin symptoms [1,2,3,4,5,6,7,8,9]. Lately, gastrointestinal symptoms have been increasingly observed [10,11,12], and also reports of affected children are available [13,14]. Merely the suspicion of histamine intolerance often leads to extensive dietary restrictions that affect not only diversity of diet but also social life. ...
... [91]. In contrast, in a more recent study by a group of Austrian researchers, DAO deficiency was found only in 8% of 394 children with chronic abdominal pain [92]. ...
... In a pediatric population under 15 years of age, Rosell-Camps et al. determined DAO deficiency in 88% of patients with abdominal pain, diarrhea and vomiting [91]. In contrast, in a more recent study by a group of Austrian researchers, DAO deficiency was found in only 8% of 394 children with chronic abdominal pain [92]. ...
Article
Full-text available
Histamine intolerance, also referred to as enteral histaminosis or sensitivity to dietary histamine, is a disorder associated with an impaired ability to metabolize ingested histamine that was described at the beginning of the 21st century. Although interest in histamine intolerance has considerably grown in recent years, more scientific evidence is still required to help define, diagnose and clinically manage this condition. This article will provide an updated review on histamine intolerance, mainly focusing on its etiology and the existing diagnostic and treatment strategies. In this work, a glance on histamine intoxication will also be provided, as well as the analysis of some uncertainties historically associated to histamine intoxication outbreaks that may be better explained by the existence of interindividual susceptibility to ingested histamine.
... Thus, the exposure of workers dealing with solid waste to the microorganisms has been considered an occupational health problem [12]. Some symptoms and illnesses associated with this activity are nausea, allergy, diarrhoea, and respiratory symptoms how coronavirus disease [13]- [16]. ...
Conference Paper
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The waste influences women's health. The quantity of waste is influencing the quality of the environment. The different cooperatives produce different types and amounts of garbage, virus, bacteria and fungi that affect the quality of life. Several protections must be used, such as masks, gloves, and boots. Solid waste is a common health problem. The analysis of different health problems is essential to verify the consequences of its inadequate management and final disposition. This paper analyses three different cooperatives about the prevalence of various diseases. The risk of chronic obstructive pulmonary disease was associated with sex and smoking, verifying that it is higher in smokers. Finally, the consequences of the inadequate management and final disposition can reflect on the health of the population.
... The most advised strategy to prevent the onset of symptoms is following a low-histamine diet (Maintz & Novak, 2007;San Mauro Martin, Brachero, & Garicano Vilar, 2016;Sánchez-Pérez et al., 2018;Tuck et al., 2019). Several clinical studies are gathering increasing evidence on the efficacy of histamine exclusion on the improvement or remissions of symptoms (Guida et al., 2000;Hoffmann, Gruber, Deutschmann, Jahnel, & Hauer, 2013;Siebenhaar et al., 2016;Wagner et al., 2017;Son, Chung, Kim, & Park, 2018). In general, low-histamine diets exclude those foods susceptible to contain histamine due to bacterial spoilage (i.e. ...
Article
Diamine oxidase (DAO) is one of the key enzymes involved in the degradation of dietary histamine. An imbalance of histamine scavenging systems leads to histamine intolerance, a diet-related disorder that may be tackled by following a low-histamine diet. Recently, the supplementation with exogenous DAO enzyme of animal origin has received the green light as a novel food to enhance intestinal degradation of histamine. This work performed a screening for histamine-degrading capacity of Leguminosae species in order to explore its potential suitability as plant-derived active ingredient of enzymatic supplements. In vitro DAO activity was determined both in raw pulses and lyophilised sprouts by an enzymatic assay coupled to UHPLC-FLD and several germination and storage conditions were assessed. The sprouts of edible legumes showed an in vitro histamine-degrading capacity ranging from 36.0 to 408.3 mU g⁻¹, much higher than that found for the non-germinated seeds (0.14–1.95 mU g⁻¹). The germination of legume seeds for 6 days in darkness provided the maximum DAO activity. Only the freezing storage of the lyophilised sprouts kept the enzymatic activity intact for at least 12 months. These results demonstrate that certain edible legumes could be suitable for the formulation of DAO supplements for the treatment of histamine intolerance.
... Histamine intolerance is caused by low levels of the histamine-degrading enzyme, diamine oxidase (DAO) and results in abnormal serum histamine levels [127]. It has been hypothesized that histamine intolerance also underlies chronic abdominal pain in children [128]. ...
Article
Full-text available
Visceral pain, characterized by abdominal discomfort, originates from organs in the abdominal cavity and is a characteristic symptom in patients suffering from irritable bowel syndrome, vulvodynia or interstitial cystitis. Most organs in which visceral pain originates are in contact with the external milieu and continuously exposed to microbes. In order to maintain homeostasis and prevent infections, the immune- and nervous system in these organs cooperate to sense and eliminate (harmful) microbes. Recognition of microbial components or products by receptors expressed on cells from the immune and nervous systems can activate immune responses but may also cause pain. We review the microbial compounds and their receptors that could be involved in visceral pain development.
... Esta desproporción facilita el aumento de histamina en plasma (6) (2) . Los síntomas más destacados son migraña, dolor de cabeza, urticaria y trastornos digestivos como flatulencias, diarrea, estreñimiento, nauseas, vómitos y dolor abdominal, entre otros (2,(7)(8)(9)(10)(11)(12)(13)(14) . ...
Article
Full-text available
Abstract Introduction & aims: Deficiency of Diamine Oxidase (DAO) enzyme, the main enzyme responsible for histamine-food metabolism, is being used as a new diagnosis to justify the appearance of different clinical symptoms, such as migraine, urticaria or some digestive disorders, among others. All of them could be related to the intake of histamine-rich food. The aim in both cases was to assess the efficacy of a lowhistamine diet in two patients with migraine and DAO deficiency. Material and methods: The two case study involves the follow-up of a 39-year-old woman and a 49-yearold woman. Both of them diagnosed with migraine that did not improve following the usual medical treatment prescribed by the doctor. Therefore, DAO activity was analysed after realizing that DAO deficiency could be related to other symptoms that they presented. Due to the results obtained, it was necessary to follow a dietary treatment with a low-histamine healthy diet and exogenous DAO enzyme supplementation. Results: After some weeks following the dietary treatment, the first case began to notice improvement in neurological symptoms. After months of follow-up she has improved not only the migraine and headache, but also respiratory, digestive and fatigue symptoms. On the other hand, in the second case, it seems to be a little improvement but migraine episodes continue almost as in the beginning. Conclusions: A low-histamine diet supplemented with exogenous DAO enzyme should be considerate as a new management in patients with migraine and DAO deficiency.
... Several clinical studies have linked DAO deficiency with the appearance of gastrointestinal (abdominal pain, diarrhoea and vomiting), dermatological (atopic dermatitis, eczema or chronic urticaria) and/or neurological (headaches) complaints [31][32][33][34][35][36][37][38][39][40][41][42]. Individuals with histamine intolerance due to DAO deficiency may suffer symptoms similar to those of intoxication, but they appear after a lower histamine intake. ...
Chapter
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Histamine is a biogenic amine involved in important physiological activities in the organism, but its ingestion through food is associated with the onset of health disorders. Histamine intoxication, previously known as scombroid fish poisoning, is caused by the intake of foods with high levels of histamine. According to official European Union reports, more than 90% of the outbreaks registered in the last years were caused by the consumption of fish and seafood products. Histamine intolerance, on the other hand, arises when histamine degradation is impaired, mainly by a lower diamine oxidase (DAO) activity. Some of the uncertainties classically associated with histamine intoxication may be explained by this enzymatic deficit in a sensitive population. This chapter reviews the adverse effects of histamine from food within a risk analysis framework, focusing specifically on the components of risk assessment and management.
... has been proposed that reduced diamine oxidase activity causes symptoms such as urticaria, flushing, rhinorrhoea and diarrhoea. Histamine intolerance has been described in children [67], but the true prevalence is unknown. An observational study in Austria reported 31 children (mean age 8 years) who presented with chronic abdominal pain, a history of ingesting histamine-rich foods and low serum diamine oxidase related to a presumed diagnosis of histamine intolerance, but it was later found that most of the children failed to show a positive response in DBPCFC. ...
Article
The prevalence of food allergy and food intolerance is increasing and it is an important public health problem affecting children. Food allergy results from an immunological reaction to certain food(s) and affects numerous organs in the body. Food intolerances are non-immunological reactions including metabolic, toxic, pharmacological and undefined mechanisms. Cow milk is the most common cause of food allergy and food intolerance, especially in young children. Food intolerance can present with similar symptoms to those of food allergy. Health-care personnel, patients and their caregivers often confuse food intolerance with food allergy. This review focuses on the clinical manifestations, diagnostic evaluation, treatment and prevention of food allergy and food intolerance.
... Obwohl wissenschaft liche Untersuchungen zur Unverträglichkeit ge genüber exogen zugeführtem Histamin bisher vorwiegend bei Erwachsenen durchgeführt wur den, wird die Diagnose auch bei Kindern und Jugendlichen gestellt, mit oftmals einschneidenden Konsequenzen für den Speiseplan der Betroffenen. Inzwischen liegen zwei Berichte über histamin abhängige Verdauungsbeschwerden im Kindes alter vor [1,2]. Eine retrospektive Beobachtungs studie aus Spanien [1] [3,4,5]. ...
Article
Adverse food reactions are far more often perceived than objectively verified. In our scientific knowledge on non-allergic adverse reactions including the so-called histamine intolerance, there are large deficits. Due to the fact that this disorder is increasingly discussed in the media and the internet, more and more people suspect it to be the trigger of their symptoms. The scientific evidence to support the postulated link between ingestion of histamine and adverse reactions is limited, and a reliable laboratory test for objective diagnosis is lacking. This position paper by the “Food Allergy” Working Group of the German Society for Allergology and Clinical Immunology (DGAKI) in collaboration with the German Association of Aller-gologists (AeDA), the Society for Pediatric Allergology and Environmental Medicine (GPA), and the Swiss Society for Allergology and Immunology (SGAI) reviews the data on the clinical picture of adverse reactions to ingested histamine, summarizes important aspects and their consequences, and proposes a practical diagnostic and therapeutic approach.
... Lange wurde das Zustandsbild nur für Erwachsene und insbesondere für Patienten mit chronisch spontaner Urtikaria und anderen Hautsymptomen postuliert [1,2,3,4,5,6,7,8,9]. Zuletzt wurde vermehrt über gastrointestinale Symptome berichtet [10,11,12] und es sind Beschreibungen über betroffene Kinder zu finden [13,14]. Bereits der Verdacht auf eine Histaminunverträglichkeit führt nicht selten zu umfangreichen diätetischen Einschränkungen, die nicht nur die Vielfalt des Speiseplans, sondern auch das Sozialleben betreffen. ...
Article
Nahrungsmittelunverträglichkeiten sind objektiv nachweisbar deutlich seltener als subjektiv empfunden. Insbesondere zum wissenschaftlichen Kenntnisstand nicht allergischer Überempfindlichkeitsreaktionen bestehen große Defizite. Ein Beispiel ist die Histaminunverträglichkeit, die aufgrund der starken Thematisierung in den Medien und im Internet von Betroffenen oftmals als Auslöser ihrer Gesundheitsbeschwerden vermutet wird. Die wissenschaftliche Evidenz für die postulierten Zusammenhänge ist begrenzt, eine verlässliche Laborbestimmung zur definitiven Diagnose nicht vorhanden. Die vorliegende Stellungnahme der Arbeitsgruppe Nahrungsmittelallergie der Deutschen Gesellschaft für Allergologie und klinische Immunologie (DGAKI) in Zusammenarbeit mit dem Ärzteverband Deutscher Allergologen (AeDA), der Pädiatrischen Allergologie und Umweltmedizin (GPA) sowie der Schweizerischen Gesellschaft für Allergologie und Immunologie (SGAI) beleuchtet die Datenlage für das Krankheitsbild der Unverträglichkeit gegenüber oral aufgenommenem Histamin, fasst wichtige Aspekte und deren Konsequenzen zusammen und schlägt ein praktikables diagnostisches und therapeutisches Vorgehen vor.
... There is also limited evidence for the efficacy of diets low in natural food chemicals. In 2013, Hoffmann et al. [109] reported that 14/394 children who presented with gastrointestinal discomfort, had both low levels of DAO and subsequently improved on a diet excluding foods high in histamine. However, the improvement was subjective, being based on a non-validated questionnaire and the dietary exclusion was not blinded. ...
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