[Food allergy. Most often conceals an inhalational allergy]

Food allergy (hypersensitivity) is a form of adverse food reaction in which the reaction is caused by an immunological response to a food. Most immediate allergic reactions to food are IgE-mediated. The prevalence of food allergy in the general population without the oral allergy syndrome is about 1-2%. Although many foods have been described to cause an allergic reaction, only a few are responsible for the majority of hypersensitivity symptoms. Based on continuous studies by B. Wüthrich, Allergy Unit of the Dermatology Department, University Hospital, Zurich, celery (42%) followed by dairy products (16%), carrot (13%), hen's egg (12%) and fish (7%) is by far the major source of food allergy in Switzerland. In adults food hypersensitivity is mainly due to cross-reactivity between inhalative and food allergens. Pathophysiologically, IgE antibodies induced by aeroallergens recognize structurally similar components in certain foods even from taxonomically unrelated plants. Following an accurate allergological examination, oral provocation tests are considered the most conclusive procedures to establish diagnosis. The only proven form of management in food allergy is strict elimination of the offending food. Food-allergic patients must be provided with emergency medications. Identification of allergens and their characterization finally will improve our understanding for pathophysiologic mechanisms of food allergy.