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2775434 
Book/Book Chapter 
Food allergy and intolerance 
Anderson, JA 
1997 
Humana Press, Inc. 
Totowa, NJ 
Allergic diseases : diagnosis and treatment 
255-274 
English 
is a chapter of 2823469 Allergic diseases : diagnosis and treatment
Adverse reactions to foods can be divided into two major groups: food allergy, which depicts an immunologic, usually involving IgE, reaction to a food, and food intolerance,which involves all other adverse reactions, some of which are the result of unknown mechanisms, but none of which involve immune reactions (see Table 1 ). Food anaphylaxis is an IgE-mediated, generalized, clinical reaction to a food because of mast cell/basophil chemical mediator release after first sensitization and then re-exposure to the same food. Anaphylactoid reactions to a food or food additive clinically resemble food anaphylaxis, but do not involve IgE sensitization and are the results of direct chemical mediator release from the mast cell/basophil.

Other terms that are occasionally used to describe types of food intolerance include food toxicity or food poisoning, idiosyncratic reactions, and pharmacologic reactions to foods. Food toxicity may be the result of natural or acquired toxins in some foods, or the result of microorganisms or parasitic contamination of natural or processed foods. Some of these clinical reactions are "allergic-like" and must be differentiated from food allergy. An idiosyncratic reaction to a food also resembles allergy, but does not involve immune mechanisms. Primary and secondary lactose sugar intolerance, because of the lack of bowel wall enzyme lactase to digest the sugar, is an example of such a reaction. Finally, a pharmacologic reaction occurs to some foods containing chemicals (e.g., caffeine), and some food additives (e.g., food colors) have drug-like effects. 
Lieberman, P; Anderson, JA 
Current clinical practice 
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