食物不耐受的鉴别诊断。
The differential diagnosis of food intolerance.
作者信息
Zopf Yurdagül, Baenkler Hanns-Wolf, Silbermann Andrea, Hahn Eckhart G, Raithel Martin
机构信息
Medizinische Klinik 1, Gastroenterologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.
出版信息
Dtsch Arztebl Int. 2009 May;106(21):359-69; quiz 369-70; 4 p following 370. doi: 10.3238/arztebl.2009.0359. Epub 2009 May 22.
INTRODUCTION
More than 20% of the population in industrialized countries suffer from food intolerance or food allergy.
METHODS
Selective literature search for relevant publications in PubMed and the Cochrane Library combined with further data from the interdisciplinary database on chronic inflammatory and allergic diseases of the Erlangen University Hospital.
RESULTS
The majority of cases of food intolerance (15% to 20%) are due to non-immunological causes. These causes range from pseudoallergic reactions to enzymopathies, chronic infections, and psychosomatic reactions that are associated with food intolerance. The prevalence of true food allergy, i.e., immunologically mediated intolerance reactions, is only 2% to 5%.
CONCLUSIONS
The differential diagnosis of food intolerance is broad. Therefore, a structured diagnostic algorithm with input from multiple clinical disciplines should be applied. The treatment consists of eliminating the offending substance from the diet as well as medications and psychosomatic support, when indicated.
引言
在工业化国家，超过20%的人口患有食物不耐受或食物过敏。
方法
在PubMed和考科蓝图书馆中进行选择性文献检索，并结合来自埃尔朗根大学医院慢性炎症和过敏性疾病跨学科数据库的进一步数据。
结果
大多数食物不耐受病例（15%至20%）是由非免疫性原因引起的。这些原因包括假性过敏反应、酶病、慢性感染以及与食物不耐受相关的身心反应。真正的食物过敏，即免疫介导的不耐受反应，患病率仅为2%至5%。
结论
食物不耐受的鉴别诊断范围广泛。因此，应采用一种由多个临床学科提供信息的结构化诊断算法。治疗包括从饮食中去除致病物质，以及在必要时使用药物和给予身心支持。
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