I believe that the presence of eosinophilia would be unusual and/or unrelated with food intolerance. If eosinophilia is present in this circumstance, it would be prudent to seek another cause. The following, from Feldman’s (textbook) Gastrointestinal and Liver Disease may be of help in this regard. Note that IgE-mediated reactions are most commonly associated with eosinophilia.
Terminology used by investigators in the field of food allergy differs slightly in different parts of the world. The following represents current terminology in the United States. An adverse food reaction is a generic term indicating any untoward reaction occurring after the ingestion of a food or food additive and may be the result of toxic or nontoxic reactions. Toxic reactions will occur in any exposed individual upon ingestion of a sufficient dose. Nontoxic reactions depend on individual susceptibilities and may be immune-mediated (food allergy or food hypersensitivity) or non–immune-mediated (food intolerance). Food intolerances comprise most adverse food reactions and are categorized as enzymatic, pharmacologic, or idiopathic food intolerances. Secondary lactase deficiency, an enzymatic intolerance, affects the vast majority of adults, whereas most other enzyme deficiencies are rare inborn errors of metabolism and thus primarily affect infants and children. Pharmacologic food intolerances are present in individuals who are abnormally reactive to substances such as vasoactive amines, which are normally present in some foods (e.g., tyramine in aged cheeses). Confirmed adverse food reactions for which the mechanism is not known are generally classified as idiopathic intolerances. Food allergies usually are characterized as IgE-mediated or non–IgE-mediated; the latter are presumed to be cell-mediated.
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