Some people may react to histamine in food, wine or beer. This may be misinterpreted as being a food or wine allergy.
Clinical features triggered by an ingestion may include:
(1) sneezing
(2) flushing
(3) skin itching
(4) headache
(5) diarrhea
(6) asthmatic symptoms with wheezing and dyspnea
(7) often negative tests for food allergy such as skin prick or RAST
A provocation test can be performed with red wine, champagne or any wine known to be high in histamine. Choosing a wine low in sulfites can help to exclude sulfite sensitivity as the cause of the reaction.
Provocation test:
(1) Draw a blood sample for baseline serum histamine level.
(2) Administer a glass of wine.
(3) A histamine-intolerant person should experience symptoms within an hour of ingestion (usually in less than 30 minutes).
(4) Draw a blood sample for histamine level during peak symptoms.
A patient who is histamine intolerant should show an increase in serum histamine from baseline.
Differential diagnosis:
(1) allergy to fermentation products
(2) allergy to sulfites
To read more or access our algorithms and calculators, please log in or register.
