Allergy to ingested cereals in atopic children

Allergy. 1994 Dec;49(10):871-6. doi: 10.1111/j.1398-9995.1994.tb00790.x.


Clinical features, hypersensitivity mechanisms, and differential diagnosis of cereal allergy or intolerance were investigated in children with atopic dermatitis (AD). On oral provocation, 18 children exhibited a positive response to wheat, three to rye, one to barley, and one to oats. Cereal-induced symptoms were dermatologic, gastrointestinal, or oropharyngeal, and their onset after provocation was immediate (eight cases), delayed (14 cases), or both immediate and delayed (one case). A combination of type I allergy tests (prick test, RAST, and histamine-release test) detected all immediate reactors and 9/14 delayed reactors. Of the five subjects remaining negative in these tests, three were positive in the patch or lymphocyte-proliferation tests. Subjects with cereal allergy or intolerance frequently possessed IgE, IgA, and IgG antibodies against gliadin, but only one of these children was HLA-DR3-positive, and none had reticulin antibodies typical of celiac disease. Combining tests of immediate and delayed hypersensitivity can confirm allergy to cereals in a more reliable way. The coexistence of cereal allergy and celiac disease seems to be rare.

MeSH terms

  • Adolescent
  • Celiac Disease / diagnosis
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Edible Grain / adverse effects*
  • Female
  • Food Hypersensitivity* / diagnosis
  • Food Hypersensitivity* / physiopathology
  • Histamine Release
  • Humans
  • Infant
  • Lymphocyte Activation
  • Male
  • Radioallergosorbent Test
  • Skin Tests