Some people develop a headache after drinking wine.
Clinical features:
(1) The person develops a headache after drinking wine, especially red wine.
(2) The person may develop a headache after eating certain foods, such as cheese or hard cured sausages.
(3) Other symptoms may include: sneezing, flushing, diarrhea, pruritis, bronchospasm.
This is thought to arise from the presence of histamine and other biogenic amines in the wine or food. If the patient is deficient in diamine oxidase then the patient may become symptomatic.
Diagnosis:
(1) precipitation of symptoms by histamine-rich foods
(2) negative allergy testing
(3) improvement with antihistamine therapy
Other family members may have similar findings.
Differential diagnosis:
(1) true food allergy
(2) hangover
(3) disulfiram-like (Antabuse) effect
