title: [Four cases of wheat-dependent exercise-induced anaphylaxis with negative gluten cap-rast score].
abstract: 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.
authors.affiliation: Department of Dermatology, Sanda City Hospital. harasusu@syd.odn.ne.jp
authors.forename: Susumu
authors.initials: S
authors.lastname: Harada
authors.forename: Maya
authors.initials: M
authors.lastname: Iijima
authors.forename: Akiko
authors.initials: A
authors.lastname: Nakamura
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Yoshizaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsuo
authors.forename: Eisin
authors.initials: E
authors.lastname: Morita
mesh_terms: 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
chemical_list: D000485:Allergens; D052179:Antigens, Plant; C475180:omega-5 gliadin, wheat; D007073:Immunoglobulin E; D005983:Glutens; D005903:Gliadin; C037302:glutenin