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Evaluation of Serum Diamine Oxidase as a Diagnostic Test for Histamine Intolerance

Histamine intolerance (HIT) is a clinical condition caused by decreased intestinal degradation of ingested histamine, primarily due to reduced enzyme diamine oxidase (DAO) activity, leading to histamine accumulation and causing various clinical manifestations. The measurement of serum DAO is commonl...

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Autores principales: Arih, Kristina, Đorđević, Nina, Košnik, Mitja, Rijavec, Matija
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10574399/
https://www.ncbi.nlm.nih.gov/pubmed/37836530
http://dx.doi.org/10.3390/nu15194246
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author Arih, Kristina
Đorđević, Nina
Košnik, Mitja
Rijavec, Matija
author_facet Arih, Kristina
Đorđević, Nina
Košnik, Mitja
Rijavec, Matija
author_sort Arih, Kristina
collection PubMed
description Histamine intolerance (HIT) is a clinical condition caused by decreased intestinal degradation of ingested histamine, primarily due to reduced enzyme diamine oxidase (DAO) activity, leading to histamine accumulation and causing various clinical manifestations. The measurement of serum DAO is commonly used as the main diagnostic test for HIT, although its diagnostic use is still uncertain. In this retrospective study, we aimed to assess the validity of DAO determination in patients with clinically suspected HIT. We measured DAO levels in 249 patients with suspected HIT and 50 healthy adult controls without HIT-related problems. Based on five clinical criteria, we divided patients into two groups: high (all five inclusion criteria; 41 patients) and low probability of HIT (≤4 inclusion criteria; 208 patients). Patients with a “high probability of HIT” had the lowest DAO (median: 8 U/mL, IQR: 6–10) in comparison to patients with a “low probability of HIT (median: 10 U/mL, IQR: 7–16, p = 0.0006) and healthy controls (median: 18 U/mL, IQR: 14–22, p < 0.0001). The specificity and sensitivity for DAO levels < 3/< 10 U/mL (manufacturer’s set cut-off) to discriminate between patients with ‘‘high probability of HIT’’ and healthy controls were 100%/92% and 2%/71%. On the other hand, the specificity and sensitivity to discriminate between patients with ‘‘high probability of HIT’’ and ‘‘low probability of HIT’’ were 97%/61% and 2%/71%, respectively. Serum DAO determination represents an additional asset to the diagnosis of HIT based on clinical evaluation and assessment, but the diagnosis should not solely rely on DAO measurements.
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spelling pubmed-105743992023-10-14 Evaluation of Serum Diamine Oxidase as a Diagnostic Test for Histamine Intolerance Arih, Kristina Đorđević, Nina Košnik, Mitja Rijavec, Matija Nutrients Article Histamine intolerance (HIT) is a clinical condition caused by decreased intestinal degradation of ingested histamine, primarily due to reduced enzyme diamine oxidase (DAO) activity, leading to histamine accumulation and causing various clinical manifestations. The measurement of serum DAO is commonly used as the main diagnostic test for HIT, although its diagnostic use is still uncertain. In this retrospective study, we aimed to assess the validity of DAO determination in patients with clinically suspected HIT. We measured DAO levels in 249 patients with suspected HIT and 50 healthy adult controls without HIT-related problems. Based on five clinical criteria, we divided patients into two groups: high (all five inclusion criteria; 41 patients) and low probability of HIT (≤4 inclusion criteria; 208 patients). Patients with a “high probability of HIT” had the lowest DAO (median: 8 U/mL, IQR: 6–10) in comparison to patients with a “low probability of HIT (median: 10 U/mL, IQR: 7–16, p = 0.0006) and healthy controls (median: 18 U/mL, IQR: 14–22, p < 0.0001). The specificity and sensitivity for DAO levels < 3/< 10 U/mL (manufacturer’s set cut-off) to discriminate between patients with ‘‘high probability of HIT’’ and healthy controls were 100%/92% and 2%/71%. On the other hand, the specificity and sensitivity to discriminate between patients with ‘‘high probability of HIT’’ and ‘‘low probability of HIT’’ were 97%/61% and 2%/71%, respectively. Serum DAO determination represents an additional asset to the diagnosis of HIT based on clinical evaluation and assessment, but the diagnosis should not solely rely on DAO measurements. MDPI 2023-10-02 /pmc/articles/PMC10574399/ /pubmed/37836530 http://dx.doi.org/10.3390/nu15194246 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Arih, Kristina
Đorđević, Nina
Košnik, Mitja
Rijavec, Matija
Evaluation of Serum Diamine Oxidase as a Diagnostic Test for Histamine Intolerance
title Evaluation of Serum Diamine Oxidase as a Diagnostic Test for Histamine Intolerance
title_full Evaluation of Serum Diamine Oxidase as a Diagnostic Test for Histamine Intolerance
title_fullStr Evaluation of Serum Diamine Oxidase as a Diagnostic Test for Histamine Intolerance
title_full_unstemmed Evaluation of Serum Diamine Oxidase as a Diagnostic Test for Histamine Intolerance
title_short Evaluation of Serum Diamine Oxidase as a Diagnostic Test for Histamine Intolerance
title_sort evaluation of serum diamine oxidase as a diagnostic test for histamine intolerance
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10574399/
https://www.ncbi.nlm.nih.gov/pubmed/37836530
http://dx.doi.org/10.3390/nu15194246
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