Table 2.

Clinical symptoms induced by blinded, placebo-controlled food challenge, atopy status and predominant type of allergy according to Coombs and Gell

Pat. No.	Main symptoms	Atopy status	Type of allergy
1	Diarrhoea, flush, pruritus	-	Type I (systemic IgE)
2	Abdominal pain, loose stools	+	Type I (systemic IgE)
	bloating
3	Vomiting, diarrhoea	+	Type I (systemic IgE)
4	Abdominal pain, urticaria	-	Type I (local IgE)
5	Diarrhoea, abdominal pain	+	Type I (systemic IgE)
	dyspepsia, vomiting
6	Diarrhoea	-	Type I (systemic IgE)
7	Vomiting, loose stools	+	Type I (systemic IgE)
	right lower quadrant pain
8	Profuse watery diarrhea	-	Type I (systemic IgE)
9	Diarrhoea, bloating, tachy-	+	Type III (immune com-
	cardia		plexes present) or IV (?)
10	Pruritus, Rhinitis, tachycardia	-	Type I (systemic IgE)
	bloating, diarrhoea
11	Colitis, diarrhoea, arthragia	-	Type I (systemic IgE)
	rhinitis
12	Bloody diarrhoea, hypotension,	-	Type I (local IgE) and
	abdominal pain, bloating		/or type III (immune
			complexes present)
13	Fever, diarrhoea, hypotension	+	Type I (systemic IgE)
14	Diarrhoea, vomiting, abdominal	-	Type IV (cellular hyper-
	pain		sensitivity ?)
15	Bloating, diarrhoea, eosinophilia	+	Type I (systemic IgE)
16	Atopic eczema, diarrhoea, colitis,	+	Type I (local IgE) and
	abdominal pain		/or type IV (cellular
			hyper-sensitivity ?)
17	Rhinitis, vomiting, diarrhoea	+	Type I (local IgE)
18	Diarrhoea, bloating	+	Type I (local IgE)
19	Eosinophilia, bloating, diarrhoea	+	Type I (systemic IgE)

Atopy status was defined as positive, when history or clinical manifestation of the patient gave evidence for milk crust, atopic eczema, asthma bronchiale and/or allergic rhino-conjunctivitis. For definition of the allergy type, the most dominant immunological signs were chosen to classify the ongoing allergic mechanisms in this population of patients with manifest gastrointestinally mediated allergy. However, some patients displayed symptoms that suggested more than one definitive type of allergy (see for example patient No. 9, 12, 16): Type I allergy (systemic IgE) was recognised when positive skin or antigen specific IgE levels were present in serum, type I allergy (local IgE) was diagnosed when intestinal lavage fluid contained elevated levels of IgE[20]. Type III allergy was found in patients no. 9 and 12 who showed formation of either IgA, IgM and/or IgE immune complexes during or after allergen application by blinded food challenge. Additionally, type IV allergy was suspected in patients with heightened serum TNF levels during food challenge, and additionally in patient no. 14 who had a positive antigen-specific lymphocyte proliferation test.