DIAGNOSIS OF FOOD ALLERGY BY COUNTING IGE-POSITIVE DUODENAL CELLS

The quantitative distribution of immunoglobulin-containing cells in th e gastric, duodenal and jejunal mucosae of 120 healthy controls and of 200 food-allergic patients, in which sensitization had been demonstra ted by the detection of IgE plasma antibodies and intestinal reactivit y by oral provocation test, has been studied after immunofluorescence staining. No patient or control subject was bearing gut parasites. The numbers of IgA-, IgM-, IgG- and IgD- containing cells were similar in patients and in controls. In food-allergic patients, the numbers of I gE-positive cells in the lamina propria was markedly increased in all small intestinal biopsy specimens studied. This was observed only in 1 18 out of 200 gastric biopsy specimens. Fifty other patients suspected of food allergy and presenting an increased number of duodenal IgE-po sitive cells were treated with oral sodium cromoglycate for a minimum of three months. Thirty-three patients reported healing or marked impr ovement. Enumerating IgE-positive cells from the duodenum, but not fro m the stomach, may be an efficient method for the diagnosis of food al lergy in patients without gut parasites.