Pseudo-allergy in its manifestations does not differ from ordinary allergies; it is also characterized by diversity clinical forms. The difference between true and pseudoallergic processes lies in their mechanism of development. False allergic reactions are triggered without the participation of immunological factors and specific sensitization to certain allergens.

Subsequent stages pathological process do not differ from those observed with allergies. This fact is important primarily for the treatment of the disease and can be determined using methods laboratory diagnostics.

A number of features help to distinguish a false allergy from a true one:

• absence allergic diseases from relatives;
• dependence of the reaction on the amount of the substance that triggers the pathochemical process;
• development of response to physical factors;
• non-specific response, therefore, in case of intolerance to several drugs or products, a pseudo-allergy is assumed, first of all;
• paraallergy can develop upon first contact with the pathogen;
• connection with general condition body and the presence of infections, with dysbacteriosis , helminthic infestations, chronic diseases, taking a large number of medications.

Classification and pathogenetic mechanisms of pseudoallergy

The disease is classified based on the characteristics of the pathogenesis of false allergic reactions.

The following variants of pseudo-allergies are distinguished:

• A form of the disease associated with impaired histamine metabolism. With this type of paraallergy, both an increased release of histamine and a violation of its inactivation may be important. A significant role in the development of paraallergy is played by the consumption of foods with increased content amines (histamine, tyramine and others): fermented cheeses, sauerkraut, legumes, raw smoked sausages, chocolate, tomatoes. Clinical manifestations are varied, in particular, urticaria and diarrhea may develop.
• Pseudoallergic reaction due to increased complement activation various substances: proteases, radiopaque agents. Given pathogenetic mechanism leads to the development of anaphylactoid reactions up to shock. Activation of complement with release of mediators from basophils, mast cells will occur when there is a deficiency or decrease in the activity of the C1 inhibitor. In this case, the triggered cascade of reactions leads to increased vascular permeability and angioedema.
• Pseudoallergy resulting from a disrupted mechanism of arachidonic acid metabolism. A classic example is the asthmatic triad that occurs in response to aspirin and other nonsteroidal analgesics.

Stages of development of allergic reactions

The fundamental difference between pseudoallergy is the absence of the first phase associated with immune mechanisms.

The pathological process of a true allergy necessarily includes 3 stages:

• Immunological, during which the formation of antigen-antibody complexes occurs, or the activation of T-lymphocytes in response to the penetration of the allergen. This step is required for true allergies.
• Pathochemical stage, which is characterized by the release of histamine and other mediators into the blood. It is from this stage that a false allergic reaction begins.
• Pathophysiological- stage clinical manifestations, the body's response to remove a pathogen from the body.

Clinical manifestations

Histamine and other mediators cause certain effects depending on the place of their release, for example, in the skin and mucous membranes - dilation of venules and increased permeability leading to edema, in the respiratory organs - bronchospasm, with a systemic effect on the cardiovascular system they can develop hypotension and shock.

Pseudoallergy can affect many body systems. Involvement in the process gastrointestinal tract manifested by abdominal pain, diarrhea, nausea, vomiting. The skin may develop rashes, redness, itching, and swelling. With pseudo-allergy, swelling and hyperemia of the eyelids, lacrimation, injection of scleral vessels, sensation foreign body. When involved in the process respiratory system Difficulty breathing, a feeling of suffocation, dry cough, swelling of the upper mucous membranes may occur. respiratory tract. Nervous system reacts to paraallergies with headaches and dizziness. From the outside cardiovascular system possible cardiac pain, arrhythmia, decreased blood pressure.

Laboratory diagnosis of pseudoallergy

Methods for laboratory confirmation of disease are aimed at identifying the pathogen and differential diagnosis true and pseudoallergic reactions. The latter is only possible by exclusion immune mechanisms. For this purpose, patients are determined eosinophil content And total IgE level , which correspond to the norm in case of paraallergy. In case of false allergic reactions, specific IgE cannot be detected; allergy tests give a negative result.

There are also specific tests that can identify certain metabolic defects. In particular, to identify the body’s response to histamine, determine diamine oxidase level in blood serum. This enzyme plays important role in the inactivation of histamine, and when its level is low, pseudo-allergic reactions of the first type are often observed.

To identify the substance that led to both a true and pseudoallergic reaction, TTML (leukocyte migration inhibition test) is used. To do this, the oral mucosa is rinsed with a weak solution of a possible allergen.

The most accurate laboratory diagnostic technologies, allowing to identify and differentiate specific sensitization and false allergic reactions, are flow cytometry methods. These include cell tests: CASC (cytometric allergen-stimulating), EK-CAST and FLOW-CAST (mediator release tests).

The prefix "pseudo" comes from Greek word"false". Pseudo-allergy (para-allergy, false allergy) is diagnosed much more often than true allergy. It accounts for up to 70% of all negative reactions to allergen irritants. Processes occur that are very similar to a real disease, but in reality they are not one. Most often, the problem appears when eating certain foods or taking medications.

General information about pseudoallergy

For appearance allergic signs The histamine compound is responsible. Histamine synthesis begins when the body comes into contact with an allergen irritant. Human immunity is provided by immunoglobulin proteins (antibodies). They bind to molecules that produce antibodies (antigens). A massive release of antibodies is defined as an “immune response.” When, as a result of the ligament, histamine is synthesized and a reaction occurs, the antigens begin to be classified as allergens. But it happens that the antibodies did not form a bond with the irritants, and the release of histamine still occurred. This is called pseudo-allergy.

With paraallergies, you can observe the same external signs, which is true, but allergic inflammatory processes are not present. Pseudo-allergy often develops as a result of chronic diseases of the intestines, stomach, and impaired metabolism fatty acids, liver diseases, pancreatic dysfunction, long-term drug therapy, various intoxications.

Except extremely rare cases failure of histamine metabolism, the synthesis of histamine in excessive amounts is provoked by liberators. This is the name given to substances, foods, etc. that enhance (release) the release of this hormone.

Liberators

The most common liberators among products:

• chocolate;
• red fish, red caviar, seafood;
• nuts;
• strawberry;
• eggs;
• citrus;
• red meat;
• soft cheese;
• red wine;
• tomatoes;
• canned food;
• cow's milk;
• wheat;
• smoked meats

The most important factor here is quantity.. For example, a person is not allergic to strawberries. If he enjoys a glass of berries, no negative reaction there won't be. But if he, as they say, “goes crazy” and eats a kilogram at once, a rash, indigestion, etc. may appear. The body simply does not have time to cope with excessive amounts of the liberator product. As a result, histamine is released and a false allergy appears. Similar phenomena It can also happen if a person eats the same strawberries, albeit not in excessive quantities, but in increased quantities for several days in a row. In this case it's going fast accumulation of irritant.

Other liberators:

• antibiotics;
• analgesics;
• ultraviolet rays;
• radiopaque compounds;
• temperature too low or high;
• various chemicals;
• nitrates, pesticides;
• preservatives, artificial food colors, flavorings, flavorings.

Symptoms

Pseudoallergic reactions are very similar to true ones. However, the symptoms false allergy directly depends on the amount of the provoking substance and is usually localized in one of the body systems.

May be observed:

• hyperemia (redness) of the skin and mucous membranes;
• blisters, rash;
• itching, peeling of the skin;
• nasal congestion, runny nose;
• lacrimation, swelling of the eyelids;
• tissue swelling (small);
• disruptions in the functions of the digestive system (nausea, diarrhea, vomiting);
• headache.

Pseudoallergy in children most often manifests itself as a skin rash, diarrhea, and dysbacteriosis. The rash usually appears first on the face, then on the body. Headaches often begin, children become capricious and sleep poorly.

The difference between the symptoms of pseudoallergy and a real reaction:

1. There is no too rapid onset of the disease.
2. The symptoms are not so severe.
3. There are almost no cases of asphyxia (suffocation), sharp decline pressure.
4. There is no severe swelling.
5. More often there are disturbances in the gastrointestinal tract.
6. Headache occurs more often.

Diagnostics

Only a specialist can distinguish a false reaction from a true allergy, since the signs are almost identical. It is necessary to contact an allergist, therapist, or pediatrician (if the child is ill). Blood samples are taken from adults and children. The level of immunoglobulin E is checked - the most important indicator. With a pseudo-allergy it will be within the normal range, and with a true allergy it will be overestimated.

Allergy tests may also be performed. A tiny number of suspected allergens are injected into small scratches. In case of paraallergy, all skin tests will be negative, that is, no redness or swelling will occur in response to any irritant.

Treatment

Once delivered correct diagnosis, the doctor must determine what exactly the negative reaction began to. The patient (or his parents, when we're talking about about the baby) must remember what food he ate over the last 2-3 days, what medications he took, perhaps he was exposed to the Sun for too long, etc.

Diet

It will be necessary to exclude from the menu the food that caused the reaction. The ban on its use lasts at least three months. Then you can try eating a small portion of the product and see how the body reacts.

The diet is also optimized. Explicitly limited harmful products(fast food, soda, canned food, smoked meats, etc.), as well as products with a high allergic index, which can act as a liberator. Need to eat more raw vegetables and fruits, dairy products, lean fish and meat, greens. It is advisable to boil, steam, or grill food.

At the same time, therapy aimed at treating chronic pathologies Gastrointestinal tract, treatment of dysbiosis. A specialist can recommend enzymes for better digestion of food and products that protect the mucous membranes from irritating factors.

Drug therapy

Treatment of pseudoallergy is practically no different from the therapy recommended for the true form of the disease. It is necessary to remove the consequences of histamine release (itching, rash, hyperemia), remove toxins and adjust the body to normal operation.

The doctor may prescribe:

1. Antihistamines - Telfast, Aleron, Xyzal, Zyrtec, Erius, Loratadine, Cetrin, etc. Syrups and drops are usually prescribed to young children. Infants are prescribed drops for oral use - Fenistil, Zodak, Parlazin, Zyrtec. Tablets for children, taking into account the drug, are prescribed either from 6 or 12 years.
2. Remedies for itching and urticaria - Soventol, Fenistil-gel, Beloderm, Psilo-balm, Lorinden, etc.
3. Vasoconstrictor drugs that remove swelling of the mucous membranes - Naphthyzin, Irifrin, Vizin, Nazol, Metazon, etc.
4. Drugs that reduce inflammation of the mucous membranes - Cromohexal, Allergokrom, Kronasol, etc.
5. Sorbents that help quickly remove toxins from the body - Laktofiltrum, Polysorb, Carbosorb, Enterosgel, for small patients - Smecta.

Traditional methods

They must be combined with traditional therapy. Consultation with a specialist is advisable, since there is a risk that folk remedies can also cause allergies.

1. 200 g large oatmeal pour 1 liter of boiling water, leave for 8-10 hours. Strain and drink little by little all day. Course – 2-3 weeks.
2. 100 g glycerin or olive oil mix with 1 tsp. dry sage powder. Apply once a day to areas of skin that are itchy and flaky.
3. Baths and compresses with a decoction of string, yarrow, chamomile, and mint help relieve itching and rashes.
4. 1 tsp Steam chamomile flowers with a glass of boiling water and strain. Drink a third of a glass three times a day before meals.
5. 2 tbsp. strings and 1 tbsp. hop cones pour 1 liter of boiling water, leave for 40 minutes. Use as a lotion for itching.

Prevention

You need to be careful about foods that can cause the release of histamine, and eat them in moderation. Often adults do not have the willpower to deny their child a few extra candies, and then they are forced to deal with allergy symptoms. In addition, you need to carefully read product labels, since there are products that do not seem to be provocateurs, but contain many preservatives and additives. Whenever possible, it is advisable to take organic fruit and vegetable products grown without chemicals.

Para-allergies, unlike a real disease, can be completely avoided. Here a lot depends on the person himself. It is enough just to comply simple rules and take a closer look at your health.

The body’s negative response to a stimulus can be not only true, but also false. Pseudoallergy accounts for more than 70% of general cases negative reactions in adults and almost 50% in children. For most patients, the problem occurs when consuming certain foods and medications.

How to prevent the development of false allergies? What types of food trigger rashes? itchy skin, tissue hyperemia without cell involvement in the process immune system? How to distinguish a true allergy from a false one? The answers are in the article.

General information

The body’s negative response to irritants is in many ways reminiscent of a normal allergic reaction; the signs are practically the same, but the reasons for the development of negative symptoms are different. Many patients do not know what the difference is between the two types of negative reactions when in contact with an irritant. It is important to know the reasons for the development of types of negative response of the body to prevent negative signs.

True allergy

Involved in the process immune cells, the level of immunoglobulin E increases, and an active release of histamine occurs. The immunological stage is an obligatory element of the reaction to the penetration of an irritant. Active production biologically active substances, inflammatory mediators leads to skin reactions, rhinorrhea, swelling, often to.

The reaction begins with a minimal amount of an inappropriate substance. With a true allergy, the body's response is often violent, with severe symptoms, sometimes life-threatening.

False allergic reaction

The same signs are present as in the true form of a negative reaction, but immune cells are not involved in the process. There is no allergic inflammation, but symptoms characteristic of an immune response to irritants appear.

The release of histamine is provoked by liberating substances:

• salicylates;
• flavoring additives;
• toxins;
• preservatives;
• synthetic food dyes;
• nitrates.

From foods (if overeating) negative symptoms provoke:

• tomatoes;
• egg white;
• seafood;
• sausage;
• strawberry;
• melons;
• canned food;
• sea ​​fish;

Sometimes pseudo-allergy is caused by:

• X-ray contrast agents;
• non-narcotic analgesics;
• some antibiotics (penicillin series);
• chemicals, household chemicals, solvents, alkalis and acids;
• low and high temperatures, UV radiation.

Important! A negative response develops only when large quantities irritant: one orange does not harm the body, but after eating a kilogram of juicy fruit, skin reactions, digestive disorders, and headaches are possible. Anaphylaxis, severe swelling, occurs less frequently than with the true form of the disease. Pseudoallergy code according to ICD -10 - T78.4 (Allergy, unspecified).

Signs and symptoms

How to distinguish an allergy from a pseudo-allergy? Doctors recommend seeking advice for early detection type of negative reaction.

With a true allergy, the body's response is so violent that pronounced swelling can develop, making breathing difficult. For this reason, the patient should not independently decide why the body is covered with a rash, the tissues are slightly swollen, tears flow, and liquid transparent mucus is released from the nose. The doctor will prescribe skin tests and tests and clarify the clinical picture.

With a false allergy, severe swelling, decreased blood pressure, and difficulty breathing rarely appear; rash, redness, itching, nausea, diarrhea, bloating, and headache occur more often. True allergies are often accompanied by severe symptoms.

Signs of allergic reactions:

• small rash, blisters;
• redness of the epidermis;
• itching (mild or severe);
• nasal congestion;
• odorless and colorless mucous discharge from the nasal passages;
• redness of the conjunctiva, itching, swelling of the eyelids;
• digestive system disorders;
• swelling of tissues varying degrees heaviness;
• decrease in pressure;
• dyspnea.

Note! The signs of true and false allergies are similar; to clarify the diagnosis, the doctor prescribes a blood test for immunoglobulin E. Based on the results, doctors give a conclusion about the causes and types of the reaction: with pseudo-allergy, the indicators will be normal; if the body’s immune system is involved in the response, the IgE level increases. Only this study allows us to distinguish between two types of negative response of the body.

Effective treatment methods and stages of therapy

Therapy for pseudoallergy begins with diagnosis, testing, and determining the factor that caused skin reactions, diarrhea, nausea, and headaches. The doctor finds out what the patient ate for two to three days before the false allergic reaction appeared, what medications he took, whether he was exposed to heat/cold or chemicals.

Stages of treatment:

• exclusion from the menu of products, after consumption of which negative signs arose. Elimination for pseudo-allergy lasts at least two to three months, preferably six months. After this period, doctors advise eating a small amount of the product and checking the reaction. In the absence of negative symptoms, you can occasionally consume a moderate amount of citrus fruits, tomatoes, cheese, and other items with a high allergic risk;
• therapy of chronic diseases, against the background of which the immune system weakens, the functioning of the digestive organs is disrupted, and problems with blood vessels appear;
• optimizing the diet, limiting foods that may cause allergies after consumption. Chocolate, seafood, citrus fruits, honey, nuts, sweets, and canned food should be present on the menu in small quantities. For pseudo-allergy negative symptoms occur only when overeating, excessive consumption of a certain name;
• normalization of the composition of microflora in the intestines. Doctors often prescribe drugs that protect mucous membranes from irritation and enzymes that speed up the digestion of food;
• reception . Important point- cleansing the body, removing breakdown products, excess salicylates, synthetic substances, remaining components medicines. Best effect provide modern sorbents that have a delicate effect on the stomach and intestines: White Coal, Polysorb, Lactofiltrum, Enterumin, Smecta, Carbosorb.

List and characteristics hormonal ointments for skin allergies, see page.

Go to the address and read about how and how to treat allergies during pregnancy.

Medicinal antihistamines

Pseudoallergy therapy includes taking antihistamines. The names are the same as for the true type of the disease. The doctor will select a product in a suitable form: tablets, gel/cream.

Pseudoallergy in children manifests itself as skin reactions and dysbacteriosis. The condition requires the prescription of drops and syrups; the tablet form is allowed after 6 or 12 years. It is important to take antihistamines under the supervision of an allergist, according to the instructions, take into account the age of the young patient and contraindications.

Pseudoallergy in adults often occurs with mild and moderately severe symptoms; modern antihistamines are required. After examining the patient, all medications are prescribed by an allergist.

Effective drugs of the latest generations:

At severe pseudo-allergies quickly relieve negative symptoms with classical antihistamines:

After recovery, it is important to follow the rules:

• eat food with synthetic additives and sweet soda less often;
• prepare healthy dishes, diversify the diet with vegetables, fermented milk products, fruits, leafy greens, lean meat, river fish;
• give up ready-made sauces, canned food, sausage, mayonnaise in favor of products made from natural ingredients;
• take care digestive system: bake, steam, less often cook fatty, fried, smoked, over-salted dishes;
• Eat all foods in moderation: it is the excessive consumption of highly allergenic foods that becomes the cause of pseudo-allergy;
• periodically visit an endocrinologist, gastroenterologist, monitor the condition of the digestive tract;
• give up uncontrolled reception medicines, especially new names. It is important to know which drugs most often provoke a negative response from the body and to carefully monitor the reaction. If rashes, redness, or swelling appear, take a pill and consult a doctor;
• give dosed physical activity, worry less, watch your weight.

Treatment of pseudoallergy is a joint task for the doctor and the patient. It is important to know why a false reaction develops, which foods and medications most often provoke the appearance of negative signs. Attention to your health, proper diet, moderate consumption any product prevents the development of pseudo-allergy. The less adults and children consume food with synthetic ingredients, the lower the risk of negative reactions.

A specialist will tell you more about what pseudo-allergy is and how to protect yourself from a negative reaction with the following video:

Pseudoallergy is a pathological reaction similar in clinical picture with a true allergy, but differing from it in the mechanism of occurrence. The second is an immune problem, while the first is an endocrine and gastroenterological problem. The development of a false reaction does not begin from the immunological phase, but immediately from the stage of release of inflammatory cellular neurotransmitters. The following cycles of the pathological process are identical for both pathologies.

Most often, the false form develops when the body is sensitive to certain types And .

False and true allergies: distinctive features

False reactions more often occur in individuals who are predisposed to them due to the presence of dysbacteriosis, as well as pathological changes in the intestines and organs urinary system. Children and people are more susceptible to it old age, while children and middle-aged people suffer more from true allergies. The development of the pseudo-reaction occurs less rapidly.

Distinctive Features pseudo- and true allergies

Peculiarities	True Current	False current
Availability of relatives	often	rarely
The presence of atopic diseases in the victim	often	rarely
The number of allergens that provoke the development of a reaction	small	significant
Correlation of allergen dose with severity of manifestations	absent	available
Results	positive	negative
Indicator of the amount of total in the blood	increased	meets the standard
Specific immunoglobulin E	determined	not defined

Factors and reasons for development

The cause of the pathology is the released organic compound - histamine. The impetus for this can be the influence of various factors.

First group

Such reactions are caused negative influence natural environment habitat per organism cellular level, leading to irreversible destruction of mast cells:

• temperature fluctuations;
• exposure to ultraviolet radiation;
• ionizing radiation.

In addition, certain chemical compounds can also provoke the release of histamine. These include:

• polymer amines;
• polysaccharides;
• antibiotics;
• toxic breakdown products of amino acids in the intestines;
• calcium ionophores;
• enzymes;
• cationic proteins of neutrophil lysosomes;
• X-ray contrast agents.

Large doses of these substances, the so-called histamine liberators, contribute to the rupture of the membrane, opening the way for the release of organic compounds, and the formation of serious allergic reactions in the form anaphylactic shock, urticaria and bronchospasm.

Second group

Developing alternative way characterized by the rapidity of its course and the absence of immune mechanisms. This pathway is activated by bacterial polymeric monosaccharides and liposaccharides.

In this case, the provocateurs are:

• medicines;
• cobra venom;
• endogenous enzymes.

Third group

Causes disruption of the metabolism of polyunsaturated fatty acids. In this case, the culprits in the development are analgesic substances that suppress the activity of cycloxygenase. Of all the products in this category, the most dynamic in internal use speakers:

• acetylsalicylic acid, Ibuprofen, Diclofenac;
• Analgin, Butadion, Amidopyrine;
• Phenacetin, Paracetamol.

Substances with the ability to nonspecifically release histamine can provoke the formation of reactions with bright severe symptoms. The source of the disease is food.

In addition, the development of a false form of allergy in a person can give rise to various food additives, as well as preservatives, the action of which is aimed at extending the shelf life of products.

Symptoms

As already mentioned, the nature of the clinical manifestations of a false allergy is similar to the signs that are observed during the formation of a true allergic reaction. During the rapid development process, the following are developing:

• violation of transcapillary exchange;
• muscle spasms;
• swelling;
• negative changes in the functioning of internal organs;
• destruction of blood cells.

The severity of the symptoms depends on which organ or system of the patient’s body has been affected the greatest defeat. The most common of them are:

• skin rash;
• cough, runny or stuffy nose, watery eyes;
• abdominal pain, vomiting, diarrhea, bloating;
• Quincke's edema;
• changes in heart rate, hypotension, difficulty breathing, loss of consciousness, suffocation.

In addition, with a strong impact on the body, the development of an anaphylactoid reaction is possible, which differs from anaphylactic shock in the absence of changes in the blood circulation system, the formation of negative signs to a greater extent in a separate organ, as well as a positive outcome.

Diagnosis of the disease

To make a diagnosis, you need to see a doctor who will perform an examination and medical history, and also prescribe the necessary tests.

Pseudoallergy is confirmed if:

• skin allergy tests are negative;
• there is no eosinophilia in the blood;
• coefficient total immunoglobulin E is within normal limits;
• the specific immunoglobulin E indicator is negative.

The need to use certain special studies is dictated by the variety of clinical manifestations:

• injection of histamine into duodenum– in case of a negative reaction to certain products;
• fluorescence of lymphocytes - with skin rashes;
• indomethacin test – for endogenous inflammation of the respiratory tract;
• elimination-challenge testing.

Treatment

After diagnosis therapeutic actions must be carried out strictly under the supervision of doctors: an allergist, and, if necessary, a dermatologist, otolaryngologist, gastroenterologist and other specialists.

Treatment includes:

1. Exclusion from the diet of foods whose consumption has led to the development of pathology. Duration is 4-6 months. After this period, the return to normal nutrition should be carried out gradually, checking the reaction to a particular product by consuming it in small doses. In the absence of negative signs, they are allowed to be taken in moderation and not often.
2. Parallel therapy of chronic diseases that provoke weakened immunity, disruptions in the functioning of the digestive and cardiovascular systems.
3. Recovery normal microflora intestines, involving the use of drugs with beneficial bacteria, and also medicinal products, protecting mucous membranes from inflammation and irritation, enzymes to improve food digestion.
4. The use of sorbents for removal from the body toxic substances ( , white coal, Lactofiltrum, Enterumin, Smecta, Carbosorb).

Preventive measures

To minimize the risk of developing pseudoallergy, you should follow certain rules:

• determine drug tolerance before use;
• exclude trigger foods from the diet;
• promptly treat diseases of the digestive system;
• avoid hypothermia and overheating;
• get rid of bad habits.

Following medical recommendations regarding work and rest schedules, dietary nutrition, the use of drugs, the chance of obtaining positive results in treatment increases significantly. To do this, you need to make every effort in the fight for recovery.

Food pseudo-allergy is a pathological process that is clinically (in terms of symptoms) similar to a true food allergy, but does not have an immune stage of development, i.e. reactions of a food allergen with a reagin antibody formed in the body. The remaining two stages of development of the pathological process with true and false allergies are similar. We are talking about the biochemical stage with the accumulation of histamine and other biologically active substances in the blood, as well as the clinical stage.

Pseudo-allergy, more often than true allergy, underlies food intolerance in individually sensitive people. It has been established that for every case food allergies there are 2-3 or more cases of pseudoallergy, and the development of the latter can be caused by both natural ingredients various products, as well as technological food additives - dyes, preservatives, etc. However, the significance of pseudo-allergic reactions to these additives should not be exaggerated; they are rare: in European countries, they occur in approximately 0.2% of the population.

Participate in the development of pseudoallergy various mechanisms, most often - histamine, the essence of which is to increase the concentration of histamine in the blood, which has a pathogenic effect on target cells. An increase in the concentration of histamine can occur in several ways, but mainly due to the direct effect of food components absorbed from the intestine on mast and other cells with the subsequent release of histamine from them. Many foods have histamine-releasing properties: fish, crustaceans, egg whites, chicken, strawberries, tomatoes, carrots, radishes, raw cabbage, mushrooms, etc. In addition, some foods are naturally high in histamine and other biologically active amines, such as cheese, red wine, fish (mackerel, tuna, mackerel, herring, salmon), chocolate, coffee, sauerkraut, spinach, tomatoes, etc. If the permeability of the intestinal mucosa is impaired or insufficient inactivation (destruction in small intestine) histamine and other amines ingested from food can cause pseudo-allergy. Weakening of histamine inactivation occurs, as a rule, in people with impaired liver function (for example, with chronic viral hepatitis), and also chronic diseases gastrointestinal tract.

The distinction between food allergy and pseudoallergy is necessary for the right choice treatments for these types of food intolerances, the causes of which lie in the characteristics of the body of some people, and not in the foods themselves, which are normal for the vast majority of people components food.

In table 1 presents the main criteria for distinguishing between food allergies and pseudo-allergies. It is necessary to note the possibility, although rare, of the simultaneous development of true and false food allergies in a person.

Table 1. Diagnostic signs allergic and pseudoallergic reactions

Signs	Allergy	Pseudoallergy
Age of onset	In childhood, often before 1 year	More often in adults
Allergic diseases in the family	Often	Rarely
Allergic diseases in the patient himself	Often	Rarely
Concomitant diseases of the digestive system	Possible, but not required	Often
Dependence on primary or secondary nutritional effects	Always in response to repeated exposure to food	Absent
The amount of substance causing the reaction	Minimum	Relatively large
Dependence of symptoms on the amount of food product	Absent	Clear dependence
Hypersensitivity to substances with a structure similar to the “suspected” allergen (cross-reactions, for example, to pollen)	Characteristic	Uncharacteristic
Elimination effect - removal of a suspected product from the diet	Eat	Fuzzy
Increased number of eosinophils in the blood	Often, often high	No or moderate
Total immunoglobulin E in the blood	Significantly increased, less often - moderately	Typically within normal limits
Presence of specific immunoglobulin in the blood	Eat	No
Skin and provocative tests with a suspected allergen	Usually positive	Negative, less often - false positive
Treatment effectiveness	Effect of specific treatment- elimination diet and immunotherapy	The effect of the complex nonspecific therapy digestive diseases

If in case of a food allergy the “culprit” product should be completely excluded from the diet, then in case of a food pseudo-allergy it is often sufficient to only reduce its quantity. However, if you have a true food allergy, it is easier to organize varied diet than with pseudoallergy. This is due to the fact that in case of an allergy, it is enough to find the product that causes it and exclude it from the diet, as in pure form, and as part of other products. Much less often we can talk about several products.

Food pseudoallergy is a nonspecific reaction of the body to different products against the background of damage to the gastrointestinal tract, liver and biliary tract. Therefore, it is crucial to treat the underlying disease while simultaneously limiting or removing it from the diet for the entire duration of treatment, potentially dangerous products. To maximize the digestion of food products that cause pseudo-allergies, you should increase the number of meals and reduce their one-time volume.

Another difference between nutrition for food allergies and nutrition for pseudo-allergies is that in case of a true allergy, the exclusion of the corresponding product will have to be followed long period, sometimes all your life, and with pseudo-allergy - you can eat varied again almost immediately after positive results therapy of the underlying disease, even if we are talking about remission (temporary improvement) in chronic pathology.

What is common in the treatment of food allergies and pseudo-allergies is the use of antihistamines, aimed at smoothing the symptoms of the disease, but not curing it.

Diagnosis of food allergy includes: 1) deciding whether the disease is allergic or pseudoallergic; 2) clarification specific product or products that lead to the development of food allergies.

To identify the food product whose components “trigger” allergic reactions, an elimination diet (from the Latin word “expel”, “remove”) is prescribed - with the exclusion of the suspected product. If allergy symptoms subside, the suspected product is reintroduced into the diet to find out whether it really is capable of causing these symptoms. It is best to confirm all positive reactions in such conditions that the patient himself does not know whether it contains this product in the food offered (blind method). As an elimination diet, the patient’s main diet is used, excluding suspected foods from it, or a diet is prescribed consisting of foods that rarely appear as sources of allergic reactions.

Define the product allergic, and other elimination diets with keeping a “Food Diary”, which are presented below, also help to eliminate it from the diet forever or until cure.

1) Strict elimination diet begins either with 1-2 fasting days on water, or with 1-3 days on slightly sweetened tea (5 glasses per day) with 250 g of dried white bread. Then every 2-3 days the diet is gradually expanded: first add fermented milk products(kefir, cottage cheese, milk, cheese - in that order), then - meat, then - fish or vegetable dishes.

2) Dairy-free diet: if you suspect an allergy to milk, exclude milk and dairy products (except butter, it is better to use baked food), as well as products containing milk: pies, cookies, etc.; It is advisable to exclude beef from food, since it may contain antigens common to milk. The duration of these diets depends on the patient’s condition and diagnosis. If the dairy nature of the allergy is confirmed, then you will need to adhere to such a diet for several months and even years, using milk substitutes.

3) Grain-free diet: foods containing flour (bread, pancakes, cakes, etc.) are excluded from the diet.

4) Fish-free diet etc.

If, against the background of an elimination diet, an exacerbation of the disease more than once coincided with taking certain products, they are excluded from the diet for a period of at least 2 weeks. If at daily use of the newly introduced product, the allergy does not worsen; after 4 days, another previously excluded product is introduced. An exacerbation of the disease when adding any product should not be scary - it just indicates that the food allergen was found correctly.