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Table 4 Erlangen symptom score used to quantify unrestricted diet, hypoallergenic diet and reactions during blinded, placebo-controlled food challenges (BPCFC)

From: Excretion of urinary histamine and N-tele methylhistamine in patients with gastrointestinal food allergy compared to non-allergic controls during an unrestricted diet and a hypoallergenic diet

I. General symptoms

1. Reduction of general condition

2. Core temperature

Mild

1

Subfebrile; 37,5 to 38,0°C

1

Moderate

2

Low fever; 38,0 to 39,0°C

2

Severe

3

High fever; >39,0°C

3

Intolerable

4

 

II. Organotropic symptoms

1. Eyes

2. CNS

- Itching/burning

- Conjunctiva

- Headache/vertigo

- Sensitivity

 

Mild

1

Erythema

1

Mild

1

Paresthesia

1

Moderate

2

Swelling unilateral

2

Severe

2

Prickling

1

Continuous

3

Swelling bilateral

3

Migraine

3

Heat (feeling)

1

3. Cardiovascular system

Decrease of blood pressure (systolic)

Increase of heart rate

 

>10 mm hg

3

>10/min

3

>20 mm hg

6

>20/min

6

>30 mm hg

10

>30/min

10

4. Respiratory systems

- Nasal congestion

- Prickling/itching (nose & pharynx)

Unilateral

1

Occasional

1

Bilateral

2

With rubbing

2

Mouth breathing

3

Continuous

3

- Rhinorrhea

- Sneezing

Occasional

1

Occasional

1

Frequently

2

Frequently

2

Continuous

3

Continuous

3

- Larynx

 

- Pulmonary function test

Hoarseness

2

FEV1 80–60% / PEF <75% (baseline)

2

Laryngeal edema

5

FEV1 < 60% / PEF < 50% (baseline)

5

- Bronchial obstruction (auscultatory)

- Cough

Expiratory wheezing

2

Occasional

1

In- & expiratory wheezing

5

Frequently

2

Massive obstruction (silent lung)

10

Staccato cough

3

5. Gastrointestinal tract

- Buccal cavity

- Abdomianl pain/cramps

Erythema/thumbness

1

Mild

1

Swelling

2

Moderate

2

Aphts

3

Severe

3

- Esophagus

- Diarrhea

Pain

1

Loose

Number of stools x 1

Dysphagia/pyrosis

2

Liquid

Number of stools x 2

Bolus (feeling)

 

3

Bloody

Number of stools x 3

- General

Meteorism

1

    

Nausea

1

    

Vomiting

Episodes x 2

    

6. Locomotor apparatus

 

- Arthralgia (including spinal column)

- Arthritis (with joint effusion)

1 joint

1

1 joint

1

2–4 joints

2

2–4 joints

2

>4 joints

3

>4 joints

3

7. Skin

- Pruritus

-Erythema

Occasional

1

Mild

2

>2 minutes

2

Moderate, <50% body surface

5

Excoriations

3

Generalized, >50% body surface

10

- Urticaria/angioedema

    

<3 hives

2

    

3–10 hives

5

    

Generalized, generalized flush

10

    
 

Result:

<3 points

Negative result

 

3–5 points

Questionable result

 

>6 points

Positive result

 
  1. Individual reactions and symptoms during the test days with unrestricted diet, potato-rice diet and during the food challenge tests were documented each for a 24 hours period and calculated for the corresponding diet and day, respectively.
  2. Food challenges were only performed when patients had a clear resolution of their symptoms under the hypoallergenic diet with symptom scores < 3 points. Symptom scores higher than 6 points were judged as positive reactions and compared with the score during potato-rice diet [11,12].
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BMC Gastroenterology

ISSN: 1471-230X

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