|
Reaction |
Clinical manifestations |
Diagnostic tests |
|
IgE-dependent | ||
|
Anaphylactic reaction (IgE-dependent) |
Onset (typically in 30 min) of urticaria, angioedema, abdominal pain, nausea, vomiting, diarrhea, rhinitis, wheeze, syncope, hypotension |
– SPT and/or sIgE – ± Oral challenge |
|
Oral allergy syndrome (IgE-dependent) |
Minutes after exposure of oral mucosa: pruritus; tingling; erythema and/or mild edema of lips, tongue, oral mucosa, and pharyngeal mucosa |
– SPT with fresh fruits/vegetables (prick-prick test) and/or sIgE – ± Oral challenge (positive with fresh and negative with cooked fruits/vegetables) |
|
IgE-dependent and non–IgE-dependent | ||
|
Eosinophilic esophagitis |
Chronic or intermittent reflux, vomiting, dysphagia |
Endoscopy (rings, furrows, edema, microabscesses, strictures, crepe paper appearance) and biopsy (>15 eosinophils/HPF) |
|
Eosinophilic gastroenteritis |
Chronic or intermittent abdominal pain, vomiting, irritability, anorexia, malnutrition, weight loss, anemia, protein-losing enteropathy |
– CBC (elevated eosinophils in 80%) – CT – Endoscopy with biopsy showing increased eosinophilic infiltration |
|
a Celiac disease and less common conditions are not included. | ||
|
CBC, complete blood count; CT, computed tomography; HPF, high power field; sIgE, serum-specific IgE; SPT, skin prick test. | ||