Journal of Nutrition and Dietetic Practice


What You Need To Know About Wheat Allergy and Wheat Dependent Exercise Induced Anaphylaxis

Author(s): Iman Hamed Nasr, Humaid Al Wahshi

Wheat allergy is the most common of the cereal grain allergies. It is caused by immunologic responses to a range of different proteins in wheat. These can be divided into Immunoglobulin E (IgE)- mediated (immediate) and/or non IgE-mediated (delayed) allergic reactions. Wheat allergy presents with a wide range of symptoms and manifestations such as exacerbation of atopic dermatitis, wheat dependent exercise-induced anaphylaxis, eosinophilic esophagitis (EoE), baker’s asthma, and celiac disease. In IgE mediated reactions, symptoms include the skin and mucus membranes, respiratory system, gastrointestinal system and cardiovascular system. Wheat dependent exerciseinduced anaphylaxis is a form of IgE mediated allergy to wheat proteins that occurs only if wheat ingestion is followed by exercise and not if wheat is ingested without exercising. Diagnosis of IgE mediated wheat allergy includes In vivo skin test, In vitro test and oral food challenge testing. Avoidance of wheat is the mainstay of treatment in wheat allergy. Avoiding eating wheat and foods containing wheat 4- 6 hours prior to exercise is advised in patients with wheat dependent exercise-induced anaphylaxis. In this article, we will focus on the IgE mediated (immediate) allergic reaction and wheat dependent exercise-induced anaphylaxis, pathogenesis, diagnosis and management.

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