Wheat-dependent, exercise-induced anaphylaxis in Thai children: a report of 5 cases.
Wheat is not an uncommon cause of food-dependent, exercise-induced anaphylaxis. This study aims to describe common clinical characteristics and laboratory manifestations of the disease. Five children, aged 8-14 years were evaluated. An atopic history was found in 20% of the patients. All patients had symptoms which involved the skin and three had hypotension. Serum specific IgE for wheat was measured and showed a positive result in 2 patients. A three-day challenge protocol with an open challenge for wheat on day 1, an exercise challenge test on day 2 and another exercise challenge test on day 3 after a meal containing wheat was performed. Four patients completed the three-day challenge protocol. Anaphylaxis occurred in 2 out of 4 patients who consumed more than 100 grams of wheat prior to the exercise. The three-day challenge protocol is a definitive diagnostic tool to confirm the diagnosis of WDEIA. However, the amount of wheat used for challenging should be at least 100 grams.
Pacharn
Punchama
P
Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Jirapongsananuruk
Orathai
O
Daengsuwan
Tassalapa
T
Vichyanond
Pakit
P
Visitsunthorn
Nualanong
N
D000293:Adolescent; D000707:Anaphylaxis / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology*; D052179:Antigens, Plant / Q000008:administration & dosage; D001250:Asthma, Exercise-Induced / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D002648:Child; D005260:Female; D006801:Humans; D007022:Hypotension; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D012867:Skin / Q000473:pathology; D012882:Skin Tests; D013785:Thailand; D014908:Triticum / Q000276:immunology*
D052179:Antigens, Plant; D007073:Immunoglobulin E