| IgE- mediated |
Acute urticaria/ angioedema |
Triggered by ingestion or direct skin contact |
Children > adults |
Depending on the triggering food |
| Rhinoconjunctivitis/asthma bronchiale |
Accompanied by food protein allergic reactions, rarely isolated respiratory symptoms (exception: inhalation exposure to aerosol of food protein, often occupational) |
Infant > adult, except occupational |
Dependent on the triggering food substance |
| Anaphylaxis |
Rapidly progressive multisystem reaction |
Any age |
Depending on triggering food and underlying disease |
| Delayed food-induced anaphylaxis to mammalian meat [267] |
Anaphylaxis three to six hours after ingestion; triggered by antibodies to galactose-α-1,3-galactose |
Adults > children |
Unclear |
| Food-dependent, risk factor-dependent anaphylaxis |
Food triggers anaphylaxis only if augmentation factors such as exertion, but also alcohol or acetylsalicylic acid (ASA) are present before or after food ingestion |
Onset in late childhood/adulthood |
Probably permanent |
| Secondary cross-allergy (mainly pollen-associated food allergies) |
Oropharyngeal itching; mild edema confined to oral cavity, less frequently urticaria perioral or generalized, Respiratory symptoms (cough); – rarely systemic reactions (incl. anaphylaxis) in some pollen-associated allergies |
Onset after manifestation of pollen allergy (adult > young child) |
May persist; may vary with seasons |
| Gastrointestinal allergic immediate reaction (allergic esophagitis, gastritis, enteritis or colitis) |
After ingestion, – depending on resorption and/or reaction site – occurring bolus sensation, vomiting, nausea, or abdominal colic, diarrhea or enterocolitis |
Any age |
Depending on the triggering food |
| Mixed IgE- and cell- mediated |
Atopic eczema/dermatitis |
Associated with food in 30 to 50% [268] of children with moderate/severe eczema |
Infant > child > adult |
Usually development of tolerance |
| Eosinophil-associated gastrointestinal inflammatory disease (EGID) |
Symptoms vary; likely persistent depending on part of gastrointestinal tract affected and degree of eosinophil inflammation |
Any age |
Unclear |
| Cell- mediated |
Food protein-induced proctitis/proctocolitis |
Mucopurulent, bloody stools in infants |
Infants |
Usually tolerance development |
| Food protein-induced enterocolitis syndrome (FPIES) |
Acute exposure: severe manifestation with vomiting, (bloody) diarrhea and exsiccosis to shock; chronic exposure: vomiting, diarrhea, failure to thrive, lethargy, Re-exposure after abstinence: vomiting, diarrhea, hypotension one to three hours after ingestion |
Infants – young children, less frequently adults [269] |
Usually development of tolerance |
| Food protein-induced enteropathy |
Diarrhea, vomiting, failure to thrive, edema; no colitis |
Infants – young children > adults |
Usually development of tolerance in children |
| Celiac disease |
Multiple manifestations, mono-, oligo- and polysymptomatic, triggered by gluten in case of genetic predisposition |
Persistent at any age (lifelong strict gluten avoidance required) |
Permanent |
| Non-allergic (non-immunological intolerance) |
Carbohydrate mal-assimilation/absorption (lactose, fructose, sorbitol, rarely: sucrose, glucose-galactose) |
Diarrhea (osmotic), meteorism, abdominal pain one to four hours after ingestion, constipation also possible |
Lactase deficiency typically from school age, otherwise any age fructose mal-absorption/sorbitol: any age, very rare: congenital lactase deficiency, glucose-galactose intolerance, sucrose-isomaltase malabsorption |
Mostly persistent (lactose, glucose-galactose); fructose, sorbitol |
