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Gastrointestinal food allergy: new insights into pathophysiology
and clinical perspectives.
Department of Gastroenterology, University Medical School of Hannover,
Germany.
Adverse reactions to food that result in gastrointestinal symptoms
are common in the general population; while only a minority of such
individuals will have symptoms due to immunologic reactions to foods,
gastrointestinal food allergies do exist in both children and adults.
These immune reactions are mediated by immunoglobulin E-dependent
and -independent mechanisms involving mast cells, eosinophils, and
other immune cells, but the complexity of the underlying mechanisms
of pathogenesis have yet to be fully defined. Knowledge of the spectrum
of adverse reactions to foods that affect the digestive system, including
gastrointestinal food allergy, is essential to correctly diagnose
and manage the subset of patients with immunologically mediated adverse
reactions to foods. Potentially fatal reactions to food necessitate
careful instruction and monitoring on the part of health care workers
involved in the care of individuals at risk of anaphylaxis. New methods
of diagnosis and novel strategies for treatment, including immunologic
modulation and the development of hypoallergenic foods, are exciting
developments in the field of food allergy.
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