title: Allergy to ingested cereals in atopic children.
abstract: 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.
authors.affiliation: Department of Clinical Medicine, University of Tampere, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Räsänen
authors.forename: M
authors.initials: M
authors.lastname: Lehto
authors.forename: K
authors.initials: K
authors.lastname: Turjanmaa
authors.forename: J
authors.initials: J
authors.lastname: Savolainen
authors.forename: T
authors.initials: T
authors.lastname: Reunala
mesh_terms: D000293:Adolescent; D002446:Celiac Disease / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D002523:Edible Grain / Q000009:adverse effects*; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000503:physiopathology; D006636:Histamine Release; D006801:Humans; D007223:Infant; D008213:Lymphocyte Activation; D008297:Male; D011852:Radioallergosorbent Test; D012882:Skin Tests