title: Age of resolution from IgE-mediated wheat allergy.
abstract: BACKGROUND
  The natural history of wheat allergy varies among different countries.
  
  
  OBJECTIVE
  To study the age of resolution from IgE-mediated wheat allergy and to define the predictors of wheat tolerance.
  
  
  METHODS
  Patients with a history of immediate reactions after wheat ingestion were enrolled. Skin prick test (SPT) and measurement of serum specific IgE (sIgE) to wheat and ω-5 gliadin were performed. Oral challenge to wheat was performed to determine wheat tolerance.
  
  
  RESULTS
  Fifty-five patients, aged 6 months to 12 years, were studied. The median age of wheat tolerance was 76 months (range 37-114 months). The percentage of children with wheat tolerance was 14.7% at age 2 years, 27% by age 4, 45.7% by age 5 and 69% by age 9. Predictors for wheat tolerance were SPT for wheat less than 3 mm of wheal diameter (hazard ratio 8.9), sIgE levels of wheat and ?-5 gliadin less than 0.35 (HR 4.3) and 0.35 kAU/L (HR 44), respectively, duration of onset of symptoms to time of physician diagnosis less than 36 months (HR 7.6) and no history of allergic rhinitis (HR 4.8).
  
  
  CONCLUSIONS
  Forty percent of children with IgE-mediated wheat allergy develop tolerance by the age of 5 years. Size of SPT, IgE level of wheat and ω-5 gliadin, time from onset of symptoms to physician diagnosis and history of allergic rhinitis are helpful for predicting wheat tolerance.
authors.affiliation: Department of Pediatrics, Siriraj Hospital, Mahidol University, Thailand.
authors.forename: Nunthana
authors.initials: N
authors.lastname: Siripipattanamongkol
authors.affiliation: Department of Pediatrics, Siriraj Hospital, Mahidol University, Thailand.
authors.forename: Pakit
authors.initials: P
authors.lastname: Vichyanond
authors.affiliation: Department of Pediatrics, Siriraj Hospital, Mahidol University, Thailand.
authors.forename: Orathai
authors.initials: O
authors.lastname: Jirapongsananuruk
authors.affiliation: Department of Pediatrics, Siriraj Hospital, Mahidol University, Thailand.
authors.forename: Jittima
authors.initials: J
authors.lastname: Veskitkul
authors.affiliation: Department of Pediatrics, Siriraj Hospital, Mahidol University, Thailand.
authors.forename: Nualanong
authors.initials: N
authors.lastname: Visitsunthorn
authors.affiliation: Department of Pediatrics, Siriraj Hospital, Mahidol University, Thailand.
authors.forename: Punchama
authors.initials: P
authors.lastname: Pacharn
mesh_terms: D000367:Age Factors; D000485:Allergens / Q000276:immunology*; D052179:Antigens, Plant / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance / Q000502:physiology; D007109:Immunity / Q000502:physiology; D007073:Immunoglobulin E / Q000097:blood*; D007223:Infant; D008297:Male; D012882:Skin Tests; D014908:Triticum / Q000276:immunology*; D021182:Wheat Hypersensitivity / Q000276:immunology*
chemical_list: D000485:Allergens; D052179:Antigens, Plant; C475180:omega-5 gliadin, wheat; D007073:Immunoglobulin E; D005903:Gliadin