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

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 le...

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Autores principales: Christensen, Morten J, Eller, Esben, Mortz, Charlotte G, Bindslev-Jensen, Carsten
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4405838/
https://www.ncbi.nlm.nih.gov/pubmed/25905008
http://dx.doi.org/10.1186/2045-7022-4-39
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author Christensen, Morten J
Eller, Esben
Mortz, Charlotte G
Bindslev-Jensen, Carsten
author_facet Christensen, Morten J
Eller, Esben
Mortz, Charlotte G
Bindslev-Jensen, Carsten
author_sort Christensen, Morten J
collection PubMed
description 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.
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spelling pubmed-44058382015-04-23 Patterns of suspected wheat-related allergy: a retrospective single-centre case note review in 156 patients Christensen, Morten J Eller, Esben Mortz, Charlotte G Bindslev-Jensen, Carsten Clin Transl Allergy Research 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. BioMed Central 2014-11-21 /pmc/articles/PMC4405838/ /pubmed/25905008 http://dx.doi.org/10.1186/2045-7022-4-39 Text en © Christensen et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Christensen, Morten J
Eller, Esben
Mortz, Charlotte G
Bindslev-Jensen, Carsten
Patterns of suspected wheat-related allergy: a retrospective single-centre case note review in 156 patients
title Patterns of suspected wheat-related allergy: a retrospective single-centre case note review in 156 patients
title_full Patterns of suspected wheat-related allergy: a retrospective single-centre case note review in 156 patients
title_fullStr Patterns of suspected wheat-related allergy: a retrospective single-centre case note review in 156 patients
title_full_unstemmed Patterns of suspected wheat-related allergy: a retrospective single-centre case note review in 156 patients
title_short Patterns of suspected wheat-related allergy: a retrospective single-centre case note review in 156 patients
title_sort patterns of suspected wheat-related allergy: a retrospective single-centre case note review in 156 patients
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4405838/
https://www.ncbi.nlm.nih.gov/pubmed/25905008
http://dx.doi.org/10.1186/2045-7022-4-39
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