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[Cereal-dependent exercise-induced anaphylaxis].

Marta Seoane-Rodríguez1, María Elisa Caralli, Cristina Morales-Cabeza

  • 1Servicio de Alergia, Hospital General Universitario Gregorio Marañón, Madrid, España. martaseoanerodriguez@gmail.com.

Revista Alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)
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PubMed
Summary

Wheat-dependent exercise-induced anaphylaxis (WDEIA) is rising. Diagnosis can be challenging, as negative omega-5-gliadin tests do not rule out WDEIA, emphasizing the need for further testing.

Keywords:
anaphylaxiscerealexercise

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Area of Science:

  • Allergy and Immunology
  • Gastroenterology

Background:

  • Wheat-dependent exercise-induced anaphylaxis (WDEIA) is an increasing concern.
  • Diagnostic methods include in vitro tests like omega-5-gliadin levels and the gold standard oral challenge test (OCT) with wheat and exercise.

Observation:

  • A case study of a 38-year-old woman with recurrent anaphylaxis post-ingestion and exercise.
  • Allergy testing revealed positive skin prick tests for wheat, barley, and rye, elevated total IgE, and positive specific IgE to wheat, barley, and rye.
  • Importantly, serum-specific IgE to rTri-a-19 omega-5 gliadin was negative.

Findings:

  • The oral challenge test (OCT) with wheat and exercise was positive, confirming WDEIA.
  • This case highlights that negative serum-specific IgE results for omega-5-gliadin and other gliadin subtypes do not exclude a WDEIA diagnosis.

Implications:

  • Clinicians should consider WDEIA even with negative omega-5-gliadin specific IgE.
  • Further diagnostic evaluation, including OCT, may be necessary for accurate WDEIA diagnosis.
  • This underscores the complexity of diagnosing food-dependent exercise-induced anaphylaxis.