SAMJ: South African Medical Journal
On-line version ISSN 2078-5135
TERBLANCHE, A J and SOUTH AFRICAN FOOD ALLERGY WORKING GROUP et al. Non-IgE-mediated food allergies. SAMJ, S. Afr. med. j. [online]. 2015, vol.105, n.1, pp. 66-66. ISSN 2078-5135. http://dx.doi.org/10.7196/SAMJ.9104.
Non-imunoglobulin E (IgE)-mediated conditions include combined IgE and cell-mediated conditions such as atopic dermatitis and eosinophilic oesophagitis, and pure T-cell-mediated conditions such as food protein-induced enterocolitis syndrome, allergic proctocolitis and enteropathy syndromes. Diagnosing mixed or non-IgE-mediated allergy is challenging. A clear cause-effect relationship between exposure to the suspected food and symptoms is not always possible, as symptoms develop over time and are more chronic in nature. Skin-prick tests and specific IgE to the allergen are usually negative. An elimination diet may be necessary to diagnose non-IgE-mediated type food allergy. The suspected allergen should be excluded from the diet for 2 - 6 weeks under dietetic guidance to assess for improvement of symptoms. After symptom improvement, a rechallenge is necessary to definitively prove causal relation.