Wheat related allergy – A retrospective single-centre study of 156 patient

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Allergy to wheat can manifest in different forms: sensitization to ingested wheat via the gastrointestinal tract can cause traditional food allergy or in combination with exercise, Wheat-Dependent Exercise-Induced Anaphylaxis (WDEIA). Sensitization to inhaled wheat flour may lead to occupational rhinitis and/or asthma.

We retrospectively investigated 156 patients (age 0.7 – 73 years) with a case history of wheat allergy. The population was divided into three groups, I: wheat allergy elicited by ingestion of wheat, II: by inhalation and III: WDEIA. All were examined with detailed case history, specific IgE (s-IgE), (Thermofischer AB, Sweden), Skin Prick Test (SPT) and wheat challenge (nasal or oral ± exercise).

Group I: Twenty one of 95 patients were challenge positive (15 children, 6 adults). All positive children had atopic dermatitis and 90 % also other food allergies. All outgrew their wheat allergy (median age for acquisition of tolerance, 1.9 years). Challenge positive patients showed significantly higher levels of s-IgE to wheat and significantly more were SPT positive and had larger wheal reactions to wheat. Challenge negative adults showed higher levels of s-IgE to pollen.
Group II: Eleven out of 13 adults with occupational asthma or rhinitis were challenge positive. None outgrew their allergy despite change in occupation. Seven had positive s-IgE and 10 had positive SPT to wheat.
Group III: Ten of 48 (adolescent and adults) were positive when challenged during exercise on a treadmill. Challenge positive patients showed significantly higher levels of s-IgE to ⍵-5 gliadin. The natural course is presently unknown.

Wheat allergy can manifest as different disease entities, rendering a detailed case history mandatory in each patient. Patient age, occupation and concomitant allergies (food or inhalant) are important factors for evaluation.
Original languageEnglish
Publication date2014
Publication statusPublished - 2014

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