title: [Intolerance to food additives: an update].
abstract: Contrary to common believing, the prevalence of the intolerance to food additives in the general population is rather low. Nowadays many doubts persist with regard both to the pathogenetic mechanisms and to the clinical and diagnostic aspects in this field. Symptoms due to, or exacerbated from, food additives usually involve non-IgE-mediate mechanisms (pseudo-allergic reactions, PAR) and are usually less severe of those induced by food allergy. The most frequent clinical feature of the intolerance to food additives still remains the urticaria-angioedema syndrome, although these substances are really involved only in a minority of patients. Other possible clinical features include anaphylaxis, atopic eczema, behaviour disturbances, asthma and non-allergic rhinitis. The diagnostic approach consists in diary cards, reporting symptoms and food habits, elimination diet and double blinded placebo-controlled oral challenge with suspected additives. However, such procedure still remains poorly standardized and numerous uncertainties persist with regard to optimal conditions for performing and interpret the challenge results. The therapeutic approach consists in the exclusion of foods and products containing the additive involved, and, in patients not compliant to the diet, in treatment with symptomatic drugs.
authors.affiliation: Clinica Pediatrica 1, Dipartimento di Biomedicina dell'Età Evolutiva, Università di Bari, Bari, Italia. fabiocardinale@libero.it
authors.forename: F
authors.initials: F
authors.lastname: Cardinale
authors.forename: F
authors.initials: F
authors.lastname: Mangini
authors.forename: M
authors.initials: M
authors.lastname: Berardi
authors.forename: M
authors.initials: M
authors.lastname: Sterpeta Loffredo
authors.forename: I
authors.initials: I
authors.lastname: Chinellato
authors.forename: A
authors.initials: A
authors.lastname: Dellino
authors.forename: F
authors.initials: F
authors.lastname: Cristofori
authors.forename: F
authors.initials: F
authors.lastname: Di Domenico
authors.forename: M F
authors.initials: MF
authors.lastname: Mastrototaro
authors.forename: A
authors.initials: A
authors.lastname: Cappiello
authors.forename: T
authors.initials: T
authors.lastname: Centoducati
authors.forename: F
authors.initials: F
authors.lastname: Carella
authors.forename: L
authors.initials: L
authors.lastname: Armenio
mesh_terms: D000485:Allergens; D002648:Child; D005503:Food Additives / Q000009:adverse effects* / Q000032:analysis; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000178:diet therapy / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006801:Humans; D015995:Prevalence; D012882:Skin Tests; D013997:Time Factors; D014581:Urticaria / Q000209:etiology
chemical_list: D000485:Allergens; D005503:Food Additives