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Table 3 List of individual symptoms, causative allergens, serum IgE and identified allergy types in each patient of the study group with gastrointestinally mediated allergy (GMA)

From: Excretion of urinary histamine and N-tele methylhistamine in patients with gastrointestinal food allergy compared to non-allergic controls during an unrestricted diet and a hypoallergenic diet

Pat. no.

Main symptoms & allergen(ssensitivity)

Atopy status & serum-IgE

Type of allergy

1

Diarrhoea, flush, pruritus

-

76

Type I (systemic IgE)

 

Soy flour, egg

   

2

Abdominal pain, loose stools

+

210

Type I (systemic IgE)

 

Bloating

   
 

Wheat, nuts

   

3

Vomiting, diarrhoea

+

112

Type I (systemic IgE)

 

Egg, wheat, soy

   

4

Abdominal pain, urticaria

-

21

Type I (local IgE)

 

Fish (salmon)

   

5

Diarrhoea, abdominal pain

+

65

Type I (systemic IgE)

 

Dyspepsia, vomiting

   
 

Hazelnut, tree pollens

   

6

Diarrhoea

-

89

Type I (systemic IgE)

 

Wheat, maize, barley

   

7

Vomiting, loose stools

+

112

Type I (systemic IgE)

 

Right lower quadrant pain

   
 

Rice, peach

   

8

Profuse watery diarrhoea

-

398

Type I (systemic IgE)

 

Milk, soy, fish

   

9

Diarrhoea, bloating, tachy-

+

34

Type III (immune com-

 

Cardia

  

Plexes present) or

 

Pork, beef, soy

  

Type IV (?)

10

Pruritus, Rhinitis, tachycardia

-

54

Type I (systemic IgE)

 

Bloating, diarrhoea

   
 

Nuts, milk

   

11

Colitis, diarrhoea, arthralgia

-

66

Type I (systemic IgE)

 

Oral allergy syndrome, rhinitis

   
 

Celery, carrot, tree & grass pollen

   

12

Bloody diarrhoea, hypotension,

-

6

Type I (local IgE)

 

And/or abdominal pain, bloating

  

Type III (IMMUNE

 

rice, soy

  

Complexes)

13

Fever, diarrhoea, hypotension

+

722

Type I (systemic IgE)

 

Nuts

   

14

Diarrhoea, vomiting, abdominal

-

6

Type IV (cellular hyper-

 

Pain

  

Sensitivity

 

cereals (rye, wheat)

   

15

Bloating, diarrhoea, eosinophilia

+

130

Type I (systemic Ige)

 

Milk, egg

   

16

Atopic eczema, diarrhoea, colitis

+

76

Type I (local IgE)

 

Abdominal pain

  

Type IV (cellular hyper-

 

Nuts, tree pollen

  

Sensitivity ?)

17

Rhinitis, vomiting, diarrhoea

+

111

Type I (local IgE)

 

Nuts, egg

   

18

Diarrhoea, bloating

+

28

Type I (local IgE)

 

Wheat, milk

   

19

Eosinophilia, bloating, diarrhoea

+

289

Type I (systemic IgE)

 

Egg

   

20

Gastrointestinal bleeding, colitis

+

80

Type I (systemic IgE)

 

Wheat, hazelnut

   

21

Chronic diarrhea, bloating, pain

-

12

Type IV

 

Pork, beef

   

22

Weight loss, diarrhea, pain

-

43

Type III (immune

 

soy

  

Complexes)

23

Loose stools, abdominal pain

+

78

Type I (local IgE)

 

Rice, egg

   

24

Diarrhea, anaphylaxis

+

312

Type I (systemic IgE)

 

Milk, egg

   

25

Weight loss, malabsorption

-

34

Type I (local IgE)

 

Milk, pork, wheat

   

26

Tachycardia, abdominal pain

-

7

Type I (local IgE)

 

Pork

   

27

Colitis, abdominal pain, pruritus

+

92

Type I (local IgE)

 

nuts, apple, tree pollen

   

28

Chronic diarrhea

-

8

Type IV

 

Rye,

   

29

Gastroesophageal reflux

+

28

Type I (local IgE)

 

Eosinophilia, intermittent diarrhea

   
 

milk, beef, tree pollen

   

30

Anaphylaxis, urticaria

+

467

Type I (systemic IgE)

 

Abdominal colics

   
 

Egg, milk

   

31

Diarrhoea, bloating

+

28

Type I (local IgE)

 

Wheat, milk

   

32

Microscopic colitis, flush

-

32

Type IV

 

Pruritus

   
 

Maize, rye

   

33

Chronic diarrhea, bloating

+

77

Type I (local IgE)

 

Abdominal pain, rhinitis

   
 

Milk, house dust mite, grass pollen

   

34

Epigastric and abdominal pain

+

420

Type I (systemic Ige)

 

Tachycardia, rhinitis, asthma bronchiale

   
 

Nuts, wheat, rye, oat

   

35

Microscopic enteritis and colitis

-

22

Type I (local IgE)

 

Malabsorption, pruritus

   
 

Egg, wheat, pork

   

36

Eosinophilic enteritis, ascites

-

71

Type I (local IgE)

 

Abdominal pain, loose stools

   
 

Maize, rice, fruits

   

37

Allergic rhinoconjunctivitis,

+

412

Type I (systemic IgE)

 

Epigastric pain, pruritus

   
 

Pollen, spice, celery

   

38

Chronic diarrhea, nausea

+

123

Type I (systemic IgE)

 

Soy, pork, rye, pollen

  

and type III (immune complexes)

39

Eosinophilic esophagitis

+

24

Type I (local IgE) and

 

Atopic dermatitis

  

Type IV

 

Egg, milk, pollen

   

40

Vomiting, flatulence,

-

8

Type IV

 

Hypotonia

   
 

Wheat, rye, soy bean, milk

   

41

Gastric & duodenal ulcer

-

91

Type I (local IgE)

 

Gastrointestinal bleeding

   
 

Eosinophilia

   
 

Soy flour, nuts, celery

   

42

Weight loss, malabsorption

+

217

Type I (systemic IgE)

 

Allergic rhinoconjunctivitis

   
 

Apple, nuts, latex

   

43

Intermittent diarrhea

-

370

Type I (systemic IgE)

 

Hazelnut

   

44

Tachycardia, restlessness

-

28

Type I (systemic IgE)

 

Loose stools

   
 

Wheat, pollen

   

45

Oral allergy syndrome,

+

198

Type I (systemic IgE)

 

Epigastric pain

   
 

Nuts, fruits, pollen

   

46

Watery diarrhea

-

36

Type I (local IgE)

 

Egg, milk

   

47

Chronic diarrhea, flatulence

-

30

Type IV

 

soy bean, beef, chicken

   

48

Urticaria, oral allergy syndrome

+

42

Type I (local IgE)

 

Colitis

   
 

Nuts, pollen

   

49

Atopic eczema, proctitis

+

732

Type I (systemic IgE)

 

Spice, pollen, hazelnut

   

50

Gastrointestinal bleeding

+

74

Type I (local IgE) and

 

From enterocolitis

  

Type IV

 

Rye

   

51

Dysphagia, epigastric pain

-

141

Type I (local IgE)

 

Oral allergy syndrome

   
 

Fruits, hazelnut, celery

   

52

Chronic diarrhea, abdominal

-

65

Type I (local IgE)

 

pain and edema

   
 

pork, maize, moulds

   

53

Lymphocytic colitis

+

122

Type I (systemic IgE)

 

Pruritus, hypotonia

  

and type IV

 

Banana, fruits

   

54

Nausea, vomiting, flatulence

+

780

Type I (systemic IgE)

 

Nuts

   

55

Oral allergy syndrome, chronic

-

96

Type I (local IgE)

 

Diarrhea

   
 

Wheat, rye

   

56

Pruritus, weight loss,

-

41

Type IV

 

Malabsorption

   
 

Wheat, rye, soy flour

   
  1. Atopy status was defined as positive, when history or clinical manifestation of the patient gave evidence for seborrheic dermatitis, atopic dermatitis or eczema, asthma bronchiale and/or allergic rhino - conjunctivitis.
  2. For definition of the allergy type, the most dominant immunological signs were chosen to classify the ongoing allergic mechanisms in this population of patients with manifest gastrointestinally mediated allergy. However, some patients displayed symptoms that suggested more than one definitive type of allergy (see for example patient No. 9, 12, 16 etc.): Type I allergy (systemic IgE) was recognised when positive skin and/or antigen specific IgE levels were present in serum, type I allergy (local IgE) was diagnosed when intestinal lavage fluid contained elevated food antigen-specific levels of IgE (>0.35 U/mg protein) [11,23].
  3. Type III allergy was found in 4 patients (no. 9, 12, 22, 38) who showed formation of either IgA, IgM and/or IgE immune complexes during or after allergen application by blinded food challenge, while pre-challenge serum immune complexes were normal during potato-rice diet.
  4. Type IV allergy was diagnosed or suspected in 8 patients who showed markedly increased production of serum TNF levels during or after food challenge, while pre-challenge TNF levels were normal during potato-rice diet. Additionally, in one patient (no. 14) type IV allergy was considered because of a positive antigen-specific lymphocyte proliferation test.