Sensitization profiles in patients with wheat-dependent exercise-induced anaphylaxis: practical aspects for allergy...

Area of Science:

• Allergy and Immunology
• Gastroenterology

Background:

• Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a condition triggered by wheat/gluten ingestion combined with exercise.
• Diagnosis involves understanding sensitization to wheat components and cofactors.

Purpose of the Study:

• To characterize the sensitization spectrum in suspected WDEIA patients.
• To correlate skin prick test (SPT) and specific IgE (sIgE) results with oral food challenge (OFC) outcomes.
• To evaluate the predictive value of diagnostic tests for WDEIA severity.

Main Methods:

• Retrospective analysis of 60 patients with sIgE against ω5-gliadin and wheat ingestion history.
• Skin prick tests (SPT) with wheat flours and gluten.
• Measurement of sIgE against wheat flour, gluten, and components.
• Correlation with medical history and OFC results.

Main Results:

• WDEIA was confirmed by OFC in approximately 75% of patients.
• Higher SPT wheal diameters for wheat flours correlated with severe anaphylaxis.
• OFC-confirmed WDEIA patients had larger SPT wheal diameters for gluten.
• sIgE levels against ω5-gliadin and gluten showed a trend towards higher values with increased anaphylaxis severity, but did not predict OFC outcomes.

Conclusions:

• Accurate medical history is essential for diagnosing anaphylaxis.
• SPT and sIgE tests are valuable diagnostic aids for WDEIA.
• Oral food challenge (OFC) is the gold standard for confirming WDEIA diagnosis.