Patterns of suspected wheat-related allergy: a retrospective single-centre case note review in 156 patients

Clinical and Translational Allergy

Carsten Bindslev-Jensen¹  Charlotte G Mortz¹  Esben Eller¹  Morten J Christensen¹ 

[1] Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense C, 5000 Odense, Denmark

关键词: ω-5 gliadin;    Wheat challenge;    Wheat allergy;    Natural course of wheat allergy;    Age dependency;   

Others  :  1092745
DOI  :  10.1186/2045-7022-4-39

 received in 2014-06-23, accepted in 2014-10-06,  发布年份 2014

【 摘 要 】

Background

Allergy to wheat can present clinically 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.

Methods

We retrospectively reviewed the case notes of 156 patients (age 0.7 – 73.3 years) with a case history of wheat allergy. The population was divided into three groups, 1: Wheat allergy elicited by ingestion, 2: By inhalation and 3: WDEIA. All patients were examined with detailed case history, specific IgE (sIgE), Skin Prick Test (SPT) and wheat challenge (nasal or oral ± exercise). Details of the case history were extracted from the patients´ case records.

Results

Group 1: Twenty one of 95 patients were challenge positive (15 children, 6 adults). All children had atopic dermatitis, and most (13/15) outgrew their wheat allergy. Most children (13/15) had other food allergies. Challenge positive patients showed significantly higher levels of sIgE to wheat and significantly more were SPT positive than challenge negative.

Group 2: Eleven out of 13 adults with occupational asthma or rhinitis were challenge positive. None outgrew their allergy. Seven had positive sIgE and 10 had positive SPT to wheat.

Group 3: Ten of 48 (adolescent/adults) were positive when challenged during exercise. Challenge positive patients showed significantly higher levels of sIgE to ω-5-gliadin. The natural course is presently unknown.

Conclusion

Wheat allergy can manifest in different disease entities, rendering a detailed case history and challenge mandatory. Patient age, occupation, concomitant allergies (food or inhalant) and atopic dermatitis are important factors for evaluation.

【 授权许可】

   
2014 Christensen et al.; licensee BioMed Central Ltd.

【 图 表 】

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