Wheat-dependent exercise-induced anaphylaxis sensitized with hydrolyzed wheat protein in soap

Allergol Int. 2012 Dec;61(4):529-37. doi: 10.2332/allergolint.12-RAI-0494. Epub 2012 Oct 25.


Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a specific form of wheat allergy typically induced by exercise after ingestion of wheat products. Wheat ω-5 gliadin is a major allergen associated with conventional WDEIA, and detection of serum immunoglobulin E (IgE) specific to recombinant ω-5 gliadin is a reliable method for its diagnosis. Recently, an increased incidence of a new subtype of WDEIA, which is likely to be sensitized via a percutaneous and/or rhinoconjunctival route to hydrolyzed wheat protein (HWP), has been observed. All of the patients with this new subtype had used the same brand of soap, which contained HWP. Approximately half of these patients developed contact allergy several months later and subsequently developed WDEIA. In each of these patients, contact allergy with soap exposure preceded food ingestion-induced reactions. Other patients directly developed generalized symptoms upon ingestion of wheat products. The predominant observed symptom of the new WDEIA subtype was angioedema of the eyelids; a number of patients developed anaphylaxis. This new subtype of WDEIA has little serum ω-5 gliadin-specific serum IgE.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Allergens / immunology*
  • Allergens / metabolism
  • Anaphylaxis / diagnosis
  • Anaphylaxis / etiology*
  • Anaphylaxis / prevention & control
  • Antigens, Plant / immunology*
  • Antigens, Plant / metabolism
  • Basophils / immunology
  • Basophils / metabolism
  • Exercise*
  • Female
  • Gliadin / immunology*
  • Gliadin / metabolism
  • Humans
  • Middle Aged
  • Phosphoric Diester Hydrolases / metabolism
  • Pyrophosphatases / metabolism
  • Soaps / adverse effects
  • Soaps / chemistry*
  • Wheat Hypersensitivity / diagnosis
  • Wheat Hypersensitivity / etiology*
  • Wheat Hypersensitivity / prevention & control


  • Allergens
  • Antigens, Plant
  • ENPP3 protein, human
  • Soaps
  • omega-5 gliadin, wheat
  • Gliadin
  • Phosphoric Diester Hydrolases
  • Pyrophosphatases