[Four cases of wheat-dependent exercise-induced anaphylaxis with negative gluten cap-rast score].
BACKGROUND
Either omega-5 gliadin or high molecular weight glutenin is known to be a major allergen in wheat-dependent exercise-induced anaphylaxis (WDEIA). It is generally considered that gluten specific IgE score is more reliable than that of wheat specific IgE score for the diagnosis of WDEIA. Our aim was to verify the significance of gluten specific IgE in the diagnosis of WDEIA.


METHODS
We evaluated the result of gluten CAP-RAST score and omega-5 gliadin specific IgE score on four WDEIA patients who visited our hospital during the years 2004 and 2005, whose diagnosis were onfirmed by prick tests, immunoblot tests and provocation tests.


RESULTS
Contrary to our expectations, all four patients showed negative gluten CAP-RAST scores, however all patient's omega-5 gliadin specific IgE scores were positive.


CONCLUSIONS
Our results suggest that gluten specific CAP-RAST score is unreliable in the diagnosis of WDEIA. On the other hand omega-5 gliadin specific IgE score is possibly a better candidate as a diagnostic tool for WDEIA.
Harada
Susumu
S
Department of Dermatology, Sanda City Hospital. harasusu@syd.odn.ne.jp
Iijima
Maya
M
Nakamura
Akiko
A
Yoshizaki
Yoshitsugu
Y
Matsuo
Hiroaki
H
Morita
Eisin
E
D000328:Adult; D000485:Allergens / Q000276:immunology*; D000707:Anaphylaxis / Q000175:diagnosis / Q000209:etiology*; D052179:Antigens, Plant; D015444:Exercise; D005260:Female; D005903:Gliadin / Q000276:immunology*; D005983:Glutens / Q000737:chemistry / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D014908:Triticum / Q000276:immunology*; D021182:Wheat Hypersensitivity / Q000276:immunology
D000485:Allergens; D052179:Antigens, Plant; C475180:omega-5 gliadin, wheat; D007073:Immunoglobulin E; D005983:Glutens; D005903:Gliadin; C037302:glutenin