Protein Intolerance Differential Diagnoses

  • Author: Agostino Nocerino, MD, PhD; Chief Editor: Carmen Cuffari, MD   more...
 
Updated: Apr 12, 2010
 
 

Differential Diagnoses

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Contributor Information and Disclosures
Author

Agostino Nocerino, MD, PhD  Chief of Pediatric Oncology, Department of Pediatrics, University of Udine, Italy

Agostino Nocerino, MD, PhD is a member of the following medical societies: American Society of Pediatric Hematology/Oncology

Disclosure: Nothing to disclose.

Coauthor(s)

Stefano Guandalini, MD  Director, University of Chicago Celiac Disease Program, Section Chief of Gastroenterology, Hepatology and Nutrition; Professor, Department of Pediatrics, University of Chicago Comer Children's Hospital

Stefano Guandalini, MD is a member of the following medical societies: American Gastroenterological Association, European Society for Paediatric Gastroenterology, Hepatology & Nutrition, and North American Society for Pediatric Gastroenterology and Nutrition

Disclosure: Nothing to disclose.

Specialty Editor Board

Chris A Liacouras, MD  Director of Pediatric Endoscopy, Department of Pediatrics, Division of Gastroenterology and Nutrition, Associate Professor, Children's Hospital of Philadelphia and University of Pennsylvania

Chris A Liacouras, MD is a member of the following medical societies: American Gastroenterological Association

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

David A Piccoli, MD  Chief of Pediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia; Professor, University of Pennsylvania School of Medicine

David A Piccoli, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American Gastroenterological Association, and North American Society for Pediatric Gastroenterology and Nutrition

Disclosure: Nothing to disclose.

Steven M Schwarz, MD, FAAP, FACN, AGAF  Professor of Pediatrics, Children's Hospital at Downstate, State University of New York Downstate Medical Center

Steven M Schwarz, MD, FAAP, FACN, AGAF is a member of the following medical societies: American Academy of Pediatrics, American College of Nutrition, American College of Physician Executives, American Gastroenterological Association, American Pediatric Society, Gastroenterology Research Group, New York Academy of Medicine, North American Society for Pediatric Gastroenterology and Nutrition, and Society for Pediatric Research

Disclosure: Curemark, LLC Consulting fee Board membership; Centocor, Inc. Grant/research funds Independent contractor; Johnson & Johnson, Inc. Grant/research funds Independent contractor

Chief Editor

Carmen Cuffari, MD  Associate Professor, Department of Pediatrics, Division of Gastroenterology/Nutrition, Johns Hopkins University School of Medicine

Carmen Cuffari, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

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Typical atopic dermatitis on the face of an infant.
Table. Classification of Main Adverse Reactions to Food
Type of Reaction Pathogenesis Clinical Entities
Non–immune-mediatedDisorders of digestive-absorptive processesGlucose-galactose malabsorption, lactase deficiency, sucrase-isomaltase deficiency, enterokinase deficiency
Pharmacological reactionsTyramine in aged cheeses, histamine (eg, in strawberries, caffeine)
Idiosyncratic reactionsFood additives, food colorants
Inborn errors of metabolismPhenylketonuria, hereditary fructose intolerance, tyrosinemia, galactosemia, lysinuric protein intolerance
Immune-mediated (food allergy)IgE-mediated (positive radioallergosorbent test or skin prick test results)Oral allergy syndrome, immediate GI hypersensitivity
Occasionally IgE-mediatedEosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis
Non–IgE-mediatedFood protein–induced entities, such as enterocolitis, enteropathy, proctocolitis, chronic constipation
AutoimmuneInnate and adaptive immunityCeliac disease
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