Increased plasma histamine concentrations after food challenges in children with atopic dermatitis

N Engl J Med. 1984 Aug 9;311(6):372-6. doi: 10.1056/NEJM198408093110605.


Thirty-three patients with atopic dermatitis underwent double-blind placebo-controlled food challenges for evaluation of the role of histamine in hypersensitivity to food. After suspect foods were eliminated for 10 days, oral challenges were performed with up to 8 g of dehydrated food. A total of 35 positive challenges elicited symptoms that were cutaneous (31), gastrointestinal (17), nasal (8), and respiratory (6) within 10 to 90 minutes. Forty-one food challenges were negative, and all 60 placebo challenges were negative. Only the group of patients with positive food challenges had a significant mean (+/- S.E.M.) rise in the plasma histamine concentration, from 296 +/- 80 pg per milliliter before challenge to 1055 +/- 356 after challenge (P less than 0.001). Rises in plasma histamine that were seen after these positive oral food challenges implicate mast-cell or basophil mediators in the pathogenesis of food allergy, including cutaneous changes in patients with atopic dermatitis.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Allergens
  • Child
  • Child, Preschool
  • Dermatitis, Atopic / blood*
  • Dermatitis, Atopic / immunology
  • Food Hypersensitivity / blood*
  • Food Hypersensitivity / immunology
  • Histamine / blood*
  • Histamine Release
  • Humans
  • Infant
  • Mast Cells / immunology


  • Allergens
  • Histamine