Two cases of wheat-dependent anaphylaxis induced by aspirin administration but not by exercise

Matsukura, Setsuko; Aihara, Michiko; Sugawara, Mariko; Kunimi, Yuko; Matsuki, Motoki; Inoue, Yuichiro; Kambara, Takeshi; Ikezawa, Zenrō

doi:10.1111/j.1365-2230.2009.03709.x

Cited by 52 publications

(57 citation statements)

References 20 publications

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“…Moreover, wheat intake is discouraged 4 h after aspirin or other cyclooxygenase-1 inhibitor intake as it might enhance WDEIA symptoms, for reasons not completely elucidated. 104 All patients should consult a dietitian for training in reading food labels. Patients should also be educated in using epinephrine autoinjectors if the onset of the allergic response is immediate and unpredictable.…”

Section: Managementmentioning

confidence: 99%

Coeliac disease and gluten-related disorders in childhood

Vriezinga

Schweizer

Koning

et al. 2015

Nat Rev Gastroenterol Hepatol

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Gluten-related disorders such as coeliac disease, wheat allergy and noncoeliac gluten sensitivity are increasingly being diagnosed in children. Coeliac disease occurs frequently, affecting 1-3% of the Western population. The condition manifests at a very young age, more so in girls, and is related to the HLA genotype. Coeliac disease might be considered a public health problem and, as primary prevention is not possible, the debate on mass screening should be reopened. Wheat proteins, including gluten, are responsible for one of the most common food allergies in children: wheat allergy. Unlike coeliac disease and wheat allergy, noncoeliac gluten sensitivity is an unclear and controversial entity. These three gluten-related disorders are treated with a gluten-free diet. In coeliac disease, the diet should be strictly followed, whereas wheat allergy only requires wheat elimination and in noncoeliac gluten sensitivity occasional trials of gluten reintroduction can be done. A good diagnostic work-up is important for gluten-related disorders in childhood to avoid unnecessary restrictive diets in children. In this Review, we provide an overview of the pathogenesis, diagnosis and management of the most common gluten-related disorders in children.

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Section: Managementmentioning

confidence: 99%

Coeliac disease and gluten-related disorders in childhood

Vriezinga

Schweizer

Koning

et al. 2015

Nat Rev Gastroenterol Hepatol

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“…The worsening of symptoms in patients with chronic urticaria and FDEIA can be due to aspirin-enhanced histamine release from basophils via increased Syk kinase activation [70][71][72]. Confounding factors also exist leading to drugs being falsely identified as the culprit.…”

Section: Risk Factorsmentioning

confidence: 99%

Drug-Induced Anaphylaxis

Blanca‐López

Plaza-Serón

Cornejo-García

et al. 2015

Curr Treat Options Allergy

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“…A unique form of allergy, WDEIA, develops predominantly in young adults and adolescents [5]. A few cases of WIA, which were enhanced by aspirin or nonsteroidal anti-inflammatory drugs, have been reported in adult patients [6,7]. We identified 4 adult patients with WIA in this study.…”

Section: Discussionmentioning

confidence: 90%

Diagnostic Value of the Serum-Specific IgE Ratio of ω-5 Gliadin to Wheat in Adult Patients with Wheat-Induced Anaphylaxis

Park

Kim

et al. 2011

Int Arch Allergy Immunol

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Background: Wheat is an important food allergen associated with severe allergic reactions, including wheat-dependent exercise-induced anaphylaxis (WDEIA) and wheat-induced anaphylaxis (WIA). To diagnose WDEIA, an exercise challenge test following wheat ingestion is performed, which is time-consuming and unsafe. The compound ω-5 gliadin has been identified as a major allergen for WDEIA and WIA. We evaluated the diagnostic value of serum immunoglobulin E (IgE) ratios of ω-5 gliadin to wheat in adult patients with WDEIA or WIA. Methods: In total, 27 patients were enrolled and classified into 2 groups according to the severity of their allergic reactions to wheat. Serum IgE, specific to wheat and ω-5 gliadin, was measured using the ImmunoCAP system. To evaluate the diagnostic value, receiver operator characteristic curves were produced. Results: Group 1 included 17 patients with a history of anaphylaxis and group 2 included 10 patients having urticaria or atopic dermatitis. Serum IgE specific to wheat was increased in 47% of group 1 and 100% of group 2. However, all patients in group 1 had high serum IgE specific to ω-5 gliadin, whereas only 20% of group 2 showed increased levels. To identify a better diagnostic value, the log-transformed IgE ratio of ω-5 gliadin to wheat was calculated, with the cutoff value at 0.3. Based on these criteria, we found 100% sensitivity and specificity. Conclusions: This study confirms that the serum IgE ratio of ω-5 gliadin to wheat may be a useful marker for the diagnosis of WDEIA and WIA.

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Two cases of wheat-dependent anaphylaxis induced by aspirin administration but not by exercise

Cited by 52 publications

References 20 publications

Coeliac disease and gluten-related disorders in childhood

Coeliac disease and gluten-related disorders in childhood

Drug-Induced Anaphylaxis

Diagnostic Value of the Serum-Specific IgE Ratio of ω-5 Gliadin to Wheat in Adult Patients with Wheat-Induced Anaphylaxis

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