Pseudo allergy

Pseudo allergieswhich cause typical allergic reactions without the presence of antibodies against the substance in question lead to as much suffering as real allergies. Diagnosis is difficult, however, as there are countless possible triggers for the symptoms. However, once suffering from a pseudo-allergy, this does not mean a lifelong waiver.

What is a pseudo allergy?

At Pseudo allergies no antibodies are involved. Instead, the pseudo-allergic reaction occurs either via histamine or via mast cells.

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Typical symptoms are identical to those of a real allergy. Those affected can experience rashes, hives, wheals, swelling and reddening of the skin. The digestive tract can also be affected. Those affected then complain of itching in the mouth or throat, stomach pain, nausea and diarrhea.

Other symptoms are asthmatic attacks, headaches, circulatory problems and runny nose. Pseudo-allergies are not preceded by a sensitization phase. This means that complaints can arise the first time you come into contact with a certain substance.

Furthermore, the reaction is strongly dependent on the amount that the person has ingested. Small amounts can be tolerated without any problems, although higher amounts can lead to life-threatening conditions.

causes

The causes for Pseudo allergies are numerous at first glance, but they are always triggers that are contained in drugs or food, which is why we speak of pseudo-allergic food intolerance.

Drugs and food additives are very often responsible for the pseudoallergic reaction. The food additives can be colorings such as quinoline yellow. Preservatives, flavor enhancers and sweeteners are also possible triggers. Another group of triggers are biogenic amines, which are found in aged hard cheese, wine and chocolate, for example.

A third group are salicylates. Salicylates are found in various fruits, vegetables and spices as well as in some medicines. In addition, natural flavorings can trigger a pseudo-allergic food intolerance. The named triggers activate mast cells unspecifically, which triggers the reaction.

These triggers should be distinguished from a reaction due to the histamine in food. If it cannot be broken down because of an enzyme deficiency, the characteristic allergy symptoms also occur here. However, this is known as histamine intolerance rather than a pseudo-allergy.

Symptoms, ailments & signs

A pseudo-allergy is associated with symptoms similar to a conventional allergy. If the sick person comes into contact with an allergen, runny nose, cough and asthmatic symptoms set in. Redness and itchy wheals develop around the skin, usually on the arms and legs, as well as on the face and neck. In addition, nasal polyps form, which can cause breathing difficulties.

They also lead to a nasal language in the patient. Nausea, vomiting and diarrhea often occur in the gastrointestinal tract. This is accompanied by headaches and the sick person often feels very unwell. Serious allergic reactions lead to circulatory problems such as palpitations, high blood pressure and dizziness up to circulatory failure.

Normally, however, a pseudo-allergy has mild symptoms. The sick person therefore often considers the symptoms to be a harmless intolerance. However, after prolonged contact with the triggering substance, the symptoms increase. As a result, the patient's quality of life decreases and there is a risk that emotional complaints will develop. A chronic pseudo-allergy can cause breathing difficulties, permanent organ damage and skin changes. Most sufferers have a sickly appearance with pale skin, puffy eyes and a stuffy nose.

Diagnosis & course

Diagnosing a Pseudo allergy turns out to be difficult due to many differential diagnoses. There may also be an allergy, an enzyme deficiency or inadequate digestion of the intestine.

In contrast to the diseases mentioned, no simple tests are available that can be used to detect a pseudo-allergy. In addition, many hours can pass before the symptoms occur, which makes finding the cause of the symptoms even more difficult. To diagnose a pseudo-allergy, the differential diagnoses should first be ruled out using skin tests, blood tests, and breath tests.

A grace period of several weeks must then be carried out, during which any possible triggers must be avoided. After that, provocation tests are carried out, which should be done under medical supervision.

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Complications

A pseudo-allergy is incorrectly referred to as intolerance or intolerance. Even if there is no real immune reaction in pseudoallergic reactions, pseudoallergies can lead to complications. For example, pseudo-allergic reactions to drugs or additives in food can potentially lead to the same symptoms as an allergy to one of the active ingredients.

The problem with pseudo-allergies, the trigger of which cannot be determined, is that they often only receive symptomatic treatment. Symptom suppression does not always work, however. The symptoms can subsequently become chronic, for example chronic pruritus, chronic urticaria or irritable bowel syndrome. Diet-related pseudo-allergies can cause periodic or persistent diarrhea and intestinal disorders.

In the event of diet-related complications, those affected usually try to exclude certain suspicious substances from the diet as a self-help measure. It can be food with a high proportion of biogenic amines. Alternatively, those affected may consider additives such as colorings or preservatives to be the cause of their problems.

In the following, avoid all foods that contain these substances. This can make the diet one-sided and unbalanced. This can lead to diet-related disorders and serious deficiency symptoms. In order to prevent further complications, an extensive search for the triggering substance would be necessary. However, this is only undertaken if a drug-related pseudo-allergy is suspected.

When should you go to the doctor?

Asthmatic complaints, circulatory reactions and gastrointestinal symptoms indicate a pseudo-allergy. A doctor should be consulted if symptoms do not resolve within a few days. If the symptoms get worse and have a very negative effect on your well-being, a visit to a doctor is recommended. People who regularly take certain medications (e.g. non-steroidal anti-inflammatory drugs or opiates) are particularly at risk. People who are sensitive to preservatives, acidulants or radiological contrast media also belong to the risk groups.

If there is a suspicion of a pseudo-allergy, these people should in any case call in their family doctor and have the symptoms clarified and, if necessary, treated. If the prescribed antihistamines or ointments do not show the desired effect, the doctor must be informed. A pseudo-allergy is treated by the family doctor, an ENT doctor or a specialist in allergic diseases. In the event of severe circulatory reactions, skin changes or even an allergic shock, you should call the emergency services. In any case, the affected person must be treated medically to avoid complications.

Treatment & Therapy

When a Pseudo allergy has been determined, the trigger (s) must first be dispensed with until the symptoms have subsided.

Only then can an increasing amount of the trigger be slowly integrated into the daily diet. In this way the individually tolerable limit value can be determined. Since they can usually tolerate a small amount of the triggering substance, those affected do not have to do without for life. However, they must check all pre-packaged goods to ensure that the relevant trigger is included.

Other goods, such as baked goods at the bakery or the portion of french fries at the fast food bar, can also contain the trigger. Caution is also advisable with medication. In some cases, however, the pseudo-allergy disappears in the course of life and those previously affected are no longer restricted in their choice of food.

In the case of acute symptoms, medication can also be taken to reduce the symptoms. A specialist can prescribe the respective medication. For example, antihistamines can be given in the event of pseudoallergic reactions.

prevention

Pseudo allergies cannot be prevented. Nevertheless, a diet with the freshest possible food and avoiding food additives is advisable.

Aftercare

Follow-up care for the pseudo-allergy is not generally necessary or required over a longer period of time. Since symptoms, like those of an allergy, occurred in the patient and had to be treated, the pseudo-allergy can recur. In order to rule out another disease, it should be determined what triggered this reaction.

The activation of the allergic reaction did not take place by activating the antibodies, but rather unspecifically, which makes treatment and thus aftercare more difficult. In many cases, there is no special aftercare or sustainable therapy for the patient. However, we know that certain substances can trigger unspecific activation and thus limit the causes.

These are specific drug groups and food ingredients. The focus is on acute treatment and is often ensured through the use of antihistamines.Follow-up care here primarily relates to the education of the patient and not to drug treatment or check-ups, as it is not possible to test antibodies in the blood.

Knowing about the pseudo-allergy, the patient is advised to record the food and medication ingested in order to be able to limit the cause accordingly and thus avoid it if it occurs again.

You can do that yourself

A pseudo-allergy can be prevented with the help of various measures and means from the household and nature. First of all, however, it is necessary to diagnose the triggering substance. Appropriate measures can then be used to specifically dispense with the triggering products.

People suffering from a pseudo-allergy should avoid contact with the trigger whenever possible. It is advisable to carefully study all lists of ingredients and contents in order to avoid contact and the associated allergic reaction. However, should a reaction occur, a doctor must be consulted. In the case of acute symptoms, the appropriate emergency medication must be taken.

A healthy diet with fresh food reduces the risk of developing a pseudo-allergy. Sufficient sleep and regular exercise also have a positive effect on the clinical picture. In addition, people who suffer from a pseudo-allergy should follow the doctor's instructions. The doctor will first recommend avoiding contact with the triggering substances. Depending on the trigger, this can be achieved by wearing appropriate clothing or by changing jobs. In the case of food allergies, the diet must be changed.