Pediatria pre prax 4/2015

Histamine intolerance

Histamine, the best documented biogenic amine, has been most frequently recognized in association with allergy. Increased concentration is in this case caused by histamine release from activated mastocytes after allergen exposure in IgE sensitized individuals. Other reason for increased histamine level may be intake of food with high histamine content or alternatively by intake of substances triggering nonspecific, non-immunologic histamine release or substances with suppressive effect on its degradation. The disequilibrium of accumulated histamine and decreased enzymatic capacity for histamine degradation was coined by term histamine intolerance. About 1% of population is estimated to be affected, mostly women in middle age. In childhood this clinical condition is not well studied and generally is considered to be rare. Clinical presentation is similar to allergies. Diagnostics is not an easy issue since reliable tests are missing. Treatment consists mostly of low histamine diet, avoiding foods and substances able to contain or release histamine, or suppress its enzymatic degradation. Important influence on histamine production is attributed to pathologic gut flora. Differential diagnosis should consider various conditions primarily affecting gastrointestinal tract.

Keywords: histamine, intolerance, diamine oxidase, diet, child.