Wheat-dependent, exercise-induced anaphylaxis in Thai children: a report of 5 cases

Asian Pac J Allergy Immunol. 2009 Jun-Sep;27(2-3):115-20.

Abstract

Wheat is not an uncommon cause of food-dependent, exercise-induced anaphylaxis. This study aims to describe common clinical characteristics and laboratory manifestations of the disease. Five children, aged 8-14 years were evaluated. An atopic history was found in 20% of the patients. All patients had symptoms which involved the skin and three had hypotension. Serum specific IgE for wheat was measured and showed a positive result in 2 patients. A three-day challenge protocol with an open challenge for wheat on day 1, an exercise challenge test on day 2 and another exercise challenge test on day 3 after a meal containing wheat was performed. Four patients completed the three-day challenge protocol. Anaphylaxis occurred in 2 out of 4 patients who consumed more than 100 grams of wheat prior to the exercise. The three-day challenge protocol is a definitive diagnostic tool to confirm the diagnosis of WDEIA. However, the amount of wheat used for challenging should be at least 100 grams.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anaphylaxis / blood
  • Anaphylaxis / diagnosis*
  • Anaphylaxis / immunology
  • Anaphylaxis / pathology
  • Anaphylaxis / physiopathology*
  • Antigens, Plant / administration & dosage
  • Asthma, Exercise-Induced / blood
  • Asthma, Exercise-Induced / diagnosis*
  • Asthma, Exercise-Induced / immunology
  • Asthma, Exercise-Induced / pathology
  • Asthma, Exercise-Induced / physiopathology*
  • Bronchial Provocation Tests
  • Child
  • Female
  • Humans
  • Hypotension
  • Immunoglobulin E / blood
  • Male
  • Skin / pathology
  • Skin Tests
  • Thailand
  • Triticum / immunology*

Substances

  • Antigens, Plant
  • Immunoglobulin E