Wheat-dependent, exercise-induced anaphylaxis in Thai children: A report of 5 cases.
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2009-06
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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 chal-lenge 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 con-sumed more than 100 grams of wheat prior to the exercise. The three-day challenge protocol is a definitive diag-nostic tool to confirm the diagnosis of WDEIA. However, the amount of wheat used for challenging should be at least 100 grams.
Abbreviations: WDEIA, wheat-dependent, exercise-induced anaphylaxis; FDEIA, food-dependent, exercise-induced anaphylaxis; SPT, skin prick test.
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Pacharn Punchama, Jirapongsananuruk Orathai, Daengsuwan Tassalapa, Vichyanond Pakit, Visitsunthorn Nualanong. Wheat-dependent, exercise-induced anaphylaxis in Thai children: A report of 5 cases. Asian Pacific Journal of Allergy and Immunology, 2009 Jun; 27(2-3): 115-120.