Continuing Medical Education

Non-IgE-mediated food allergies

A J Terblanche, A C Lang, C L Gray, E Goddard, S Karabus, M Kriel, A I Manjra, S M Risenga, D A van der Spuy, M E Levin

Abstract


Non-imunoglobulin E (IgE)-mediated conditions include combined IgE and cell-mediated conditions such as atopic dermatitis and eosinophilic oesophagitis, and pure T-cell-mediated conditions such as food protein-induced enterocolitis syndrome, allergic proctocolitis and enteropathy syndromes. 

Diagnosing mixed or non-IgE-mediated allergy is challenging. A clear cause-effect relationship between exposure to the suspected food and symptoms is not always possible, as symptoms develop over time and are more chronic in nature. Skin-prick tests and specific IgE to the allergen are usually negative. An elimination diet may be necessary to diagnose non-IgE-mediated type food allergy. The suspected allergen should be excluded from the diet for 2 - 6 weeks under dietetic guidance to assess for improvement of symptoms. After symptom improvement, a rechallenge is necessary to definitively prove causal relation.

 

Authors' affiliations

A J Terblanche, Department of Paediatrics, Faculty of Health Sciences, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa

A C Lang, Wits Donald Gordon Medical Centre, Johannesburg, South Africa

C L Gray, Private Practice, Vincent Pallotti Hospital, Pinelands, Cape Town, South Africa

E Goddard, Division of Paediatric Gastroenterology, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

S Karabus, Private Practice, Christiaan Barnard Memorial Hospital, Cape Town, and Division of Allergy, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

M Kriel, Private Practice, Alberton, Johannesburg, South Africa

A I Manjra, Private Practice, Westville, Durban, South Africa

S M Risenga, Department of Pulmonology and Allergy, Faculty of Health Sciences, Polokwane Campus, University of Limpopo, Polokwane, South Africa

D A van der Spuy, Private Practice, Cape Town, South Africa

M E Levin, Division of Allergy, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

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Keywords

Non-IgE; Food allergies

Cite this article

South African Medical Journal 2015;105(1):66. DOI:10.7196/SAMJ.9104

Article History

Date submitted: 2014-10-29
Date published: 2014-11-23

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