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.
Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Punchama
P
Pacharn
Orathai
O
Jirapongsananuruk
Tassalapa
T
Daengsuwan
Pakit
P
Vichyanond
Nualanong
N
Visitsunthorn
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