title: Clinical and laboratory features, and quality of life assessment in wheat dependent exercise-induced anaphylaxis patients from central China.
abstract: Wheat dependent exercise-induced anaphylaxis (WDEIA) is a rare but potentially severe food allergy caused by the combination of wheat ingestion and physical exercise. The impact of WDEIA on quality of life (QOL) is unclear. This study characterized the clinical and laboratory features and investigated the QOL in WDEIA patients from Central China. Twenty-eight WDEIA patients were analyzed, and QOL was measured by validated Chinese version Food Allergy Quality of Life Questionnaire-Adult Form (FAQLQ-AF) and Food Allergy Independent Measure (FAIM) after obtaining the diagnosis. The results showed that half of the patients were females. The median onset age was 37 years old. The symptoms occurred within 1 h after wheat ingestion (26/28). Symptoms of anaphylaxis included cutaneous (26/28), respiratory (11/28), gastro-intestinal (5/28) and cardiovascular manifestations (27/28). Skin prick tests were positive to salt soluble (89.3%) and salt insoluble wheat allergen extracts (100%). Positive rate to wheat, gluten and omega-5 gliadin specific IgE was 64.3%, 92.9% and 92.9% respectively. Specific IgE to omega-5 gliadin with a cut-off value 0.83 KU/L offered highly efficient diagnostic criterion for WDEIA (sensitivity: 89.3%; and specificity: 88.9%). The mean scores of FAQLQ-AF and FAIM were 4.70 and 4.98 respectively and level of anti-omega-5 gliadin IgE had positive correlations with FAQLQ scores. Thereby, WDEIA is commonly found in mid-age adults. In most cases, multi-organs especially skin and cardiovascular systems are involved. Salt insoluble wheat allergen skin test and serum specific IgE to gluten and omega-5 gliadin help to diagnose WDEIA. QOL in WDEIA patients is severely impaired.
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Huang
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Wen-Jing
authors.initials: WJ
authors.lastname: Li
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Dong
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Shan-Shan
authors.initials: SS
authors.lastname: Qi
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: You-Na
authors.initials: YN
authors.lastname: Wang
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Guang-Hui
authors.initials: GH
authors.lastname: Liu
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. zrf13092@163.com.
authors.forename: Rong-Fei
authors.initials: RF
authors.lastname: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000008:administration & dosage / Q000737:chemistry / Q000276:immunology*; D000707:Anaphylaxis / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000523:psychology*; D002681:China; D015444:Exercise; D005260:Female; D041981:Gastrointestinal Tract / Q000276:immunology / Q000503:physiopathology; D005903:Gliadin / Q000008:administration & dosage / Q000737:chemistry / Q000276:immunology*; D006321:Heart / Q000503:physiopathology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008168:Lung / Q000276:immunology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012867:Skin / Q000276:immunology / Q000503:physiopathology; D012882:Skin Tests; D011795:Surveys and Questionnaires; D014908:Triticum / Q000737:chemistry* / Q000276:immunology; D021182:Wheat Hypersensitivity / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000523:psychology*
chemical_list: D000485:Allergens; D007073:Immunoglobulin E; D005903:Gliadin
keywords: Central China; IgE; anaphylaxis; quality of life; wheat allergy