Food allergy and intolerance in 100 patients---local and systemic effects

One hundred patients who reacted adversely to one or more specific foods were studied. In 93 the food induced symptoms included asthma, eczema, angioedema, urticaria, rhinorrhoea, or a combination of one or more of these with gastrointestinal symptoms. The remaining seven had gastrointestinal symptoms only. The diagnosis of food allergy was made on the on the basis of a definite, immediate allergic reaction to specific foods or a reaction that was suggestive of allergy, supported by a corresponding positive skin prick or radioallergosorbent test. In the absence of such evidence, the less specific diagnosis of 'food intolerance' seemed preferable. Test materials appeared to differ in their diagnostic usefulness. A high proportion (c. 75 per cent) of patients who were intolerant to egg, fish or nuts had positive test results. In contrast, only 30 per cent of patients with milk intolerance had positive tests, suggesting inadequate test methods or a non-allergic cause for many patients' milk intolerance. Nevertheless, five milk intolerant patients with negative tests had milk-induced asthma.