Abstract

Histamine intolerance

Histamine is a biogenic amine with complex physiologic functions and pathologic reactions. Histamine intolerance (HIT) is defined by increased histamine and low diaminoxidase (DAO, histamine degrading enzyme) or both. Clinical pictures of HIT comprise headaches, migraine, blocked or running nose, cardiac arrhythmia, bronchial asthma, gastrointestinal disturbances especially diarrhoea, low blood pressure, dysmenorrhea and urticaria. Nausea and vomiting in seasickness and pregnancy are caused by histamine. In the first trimenon of pregnancy DAO increases 100fold and remains then stable from the 12th week of pregnancy onward. Lack of DAO increase leads to elevated histamine levels and hyperemesis gravidarum, risk for abortion and preeclampsia. In high risk pregnancies repeated measures of DAO therefore have been proposed. PONV (postoperative nausea and vomiting) is seen in one third of operated patients and is treated routinely with antihistamines. Intolerance of red wine is usually the first clinical sign of HIT. Diagnosis and treatment can be performed easily: determination of histamine and DAO prior and after a 14 days histamine free diet. Clinical improvement, decrease of histamine and increase of DAO underlines HIT. Additional antihistamines, DAO containing capsules and vitamin C is recommended. Whether supplementation of copper (DAO contains copper) is helpful, has not been proved in detail yet.

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2017; 13(2): 104–114

Keywords
Histaminintoleranz, Migräne, Seekrankheit, PONV, Schwangerschaftsübelkeit

Reinhart Jarisch
FAZ Floridsdorfer Allergiezentrum Wien
Reviewer: Marcus Maurer, Berlin,
und Arndt Runge, Hamburg

Jarisch R. Histaminintoleranz ... Gynakol Geburtsmed Gynakol Endokrinol 2017; 13(2): 104–114 publiziert 31.07.2017 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2017 ISSN 1614-8533