"In truth, question everything"....

This blog post on an allergy blog I follow: Grading the Severity of your Allergy: Sensitivity vs. Reaction Level, gives good advice on how to decipher your reaction levels, your severity.  What do you (or your child) react to?   Everything in the air?  Cross contamination?  Trace proteins?  Food families? Through breastmilk?  Through feed from the animal contaminating the meat?  Through formula?  On the skin?

With Non-IgE allergy, just as with an IgE Allergy, even the blood and skin tests will not tell the severity of an allergy; it will only tell the positive antibody production and the probability of reaction.   The only tried and true way to tell a person's reaction level is by testing it with elimination and challenge.  Eliminate the food from the diet, if symptoms subside, there are good chances you are allergic and need to eliminate that food, and all derivatives of it from the diet.  Some reaction symptoms are obvious enough you don't have to, nor would you want to, challenge the food.   A challenge would consist of a re-introduction of the food once suspected symptoms have resolved.  This challenge can also help determine severity of the allergy; as addressed in the above blog article.   Some people react to any and all minute derivatives or cross contamination of the allergen, some can handle derivatives or oils, etc.  The only true way to know is to challenge, and in the meantime- question everything.

IgE Allergy vs. Non-IgE Allergy

IgE FOOD ALLERGY: (Typical food allergy) Immediate onset reactions	Non- IgE Food Allergy: (PROTEIN INTOLERANCE) Delayed onset reactions
The body's abnormal immune response to a food, usually a protein.	Mediated by non-IgE antibodies and/or cellular immune responses.
Common Conditions*: 1.     IgE food allergy (ie egg, milk, peanut, tree nut, soy, wheat, shell fish…) 2.     Eosinophilic Disorders 3.     Oral Allergy Syndrome *list is not inclusive, please see your doctor for any symptoms/diagnosis	Common conditions*: 1.     Milk/Soy Protein Intolerance 2.     Multiple Food Protein Intolerance 3.     Food protein-Induced Allergic Protocolitis 4.     Food Protein Induced Enterocolitis Syndrome 5.     Food Protein Enteropathy 6.     Celiac Disease (also auto-immune) 7.     Eosinophilic Disorders (also IgE) *list is not inclusive, please see your doctor for any symptoms/diagnosis
Common Respiratory Symptoms: ·          Sneezing, runny nose, congestion, hay fever ·          Shortness of breath ·          Throat swelling ·          Cough ·          Allergic asthma ·          Pink eye/eye swelling	Common Respiratory Symptoms: ·          Non-allergic sneezing, congestion, runny nose ·          Non-atopic cough, asthma ·          Recurrent or chronic sinus inflammation/infections ·          Reflux disease ·          Recurrent ear infections ·          Eye swelling ·          Enlarged adenoids
COMMON GI SYMPTOMS: Nausea/Vomiting/Diarrhea Cramping abdominal pain Reflux/Difficulty swallowing Swelling (tongue,lips,face) Itching/swelling of the tongue, lips, mouth Dizziness Fainting Severe reactions (anaphylaxis) can be life threatening and require immediate medical attention and can include: Itching or tightness in the throat Difficulty breathing Wheezing/coughing Rapid heart rate Low blood pressure Loss of consciousness Symptoms usually occur within minutes to 1-2 hours after ingesting the food.	COMMON GI SYMPTOMS for MSPI/MFPI: Mucus/Blood in Stools Inconsolable and Extended Crying/Colic Disrupted Sleep Malabsorption/Vitamin Deficiency "Spit-up" an hour+ after feeding Sulfur/sour smelling stools Diarrhea and/or constipation Red ring around the anus Peeling diaper rash Gas/wind Mouth itching Dysbiosis Symptoms can occur hours to days after ingesting the food. COMMON SYMPTOMS for FPIES will include above and: Loss of appetite Violent/forceful/projectile vomiting Lethargy Dehydration Low body temp or fever Low blood pressure Shock Click here for more information on: Celiac, Eosinophilic disorders
Common skin symptoms: ·          Eczema ·          Hives ·          Rashes (dermatitis)	Common skin symptoms: ·          Eczema ·          Rashes/flushing ·          Itchy skin ·          Diaper rash.
Diagnostic Tests: ·          RAST (serum IgE) ·          Skin Prick Testing ·          EE requires endoscopy	Diagnostic Tests: ·          Atopy Patch Testing ·          Food elimination and challenge ·          Endoscopy/colonoscopy ·          Medical history

References:

Non-IgE food Allergy by Dr.Jyonouchi http://www.pcrcd.org/Jyonouchi_IA-DT.pdf 

2010 Guidelines for Diagnosis and Management of Food Allergy in the United States  http://www.niaid.nih.gov/topics/foodallergy/clinical/Pages/default.aspx

Protein Intolerances  http://emedicine.medscape.com/article/931548-overview