Wheat‐dependent exercise‐induced anaphylaxis

@article{Scherf2016WheatdependentEA,
  title={Wheat‐dependent exercise‐induced anaphylaxis},
  author={Katharina Anne Scherf and Knut Brockow and Tilo Biedermann and Peter Koehler and Herbert Wieser},
  journal={Clinical \& Experimental Allergy},
  year={2016},
  volume={46},
  pages={10 - 20}
}
Wheat‐dependent exercise‐induced anaphylaxis (WDEIA) is a rare, but potentially severe food allergy exclusively occurring when wheat ingestion is accompanied by augmenting cofactors. It is clinically characterized by anaphylactic reactions ranging from urticaria and angioedema to dyspnoea, hypotension, collapse, and shock. WDEIA usually develops after ingestion of wheat products followed by physical exercise. Other cofactors are acetylsalicylic acid and other non‐steroidal anti‐inflammatory… 
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116 Citations
Highly Influential Citations
3
Background Citations
29
Methods Citations
1
Results Citations
1

116 Citations

Wheat-Dependent Exercise-Induced Anaphylaxis

TLDR
Patients with WDEIA experience allergic symptoms when they exercise following wheat consumption and there is no evidence that anti-histamines and corticosteroids have lifesaving effects, so it is important that adrenaline auto-injector is used in an appropriate setting and that the patient is transferred to a hospital immediately.

Cofactors of wheat-dependent exercise-induced anaphylaxis do not increase highly individual gliadin absorption in healthy volunteers

TLDR
The adsorption of gliadin in the gut in healthy volunteers is less dependent on cofactors than has been hypothesized and may play the major role in WDEIA.

The basophil activation test differentiates between patients with wheat‐dependent exercise‐induced anaphylaxis and control subjects using gluten and isolated gluten protein types

TLDR
This study shows the alternative role of BAT in better defining WDEIA and the causative wheat allergens in patients and controls with a sensitivity/specificity of 100/70 and 75/100, respectively.

Wheat-Dependent Cofactor-Augmented Anaphylaxis: A Prospective Study of Exercise, Aspirin, and Alcohol Efficacy as Cofactors.

Exercise-food challenge test in patients with wheat-dependent exercise-induced anaphylaxis.

TLDR
For WDEIA, time to diagnosis was delayed, and one-third of patients had recurrent acute urticaria proceeding anaphylaxis onset, and the exercise-food challenge test could be utilized safely in both children and adult and able to elicit symptoms in two-thirds of patients.

A New Diagnostic Criteria of Wheat-Dependent, Exercise-Induced Anaphylaxis in China

TLDR
It is suggested that confirmed anaphylactic reactions triggered by wheat with positive sIgE to gluten and omega-5-gliadin may provide supportive evidence for clinicians to make WDEIA diagnosis without performing a food exercise challenge.

Wheat-dependent exercise-induced anaphylaxis with Tri-a-14-sensitization as part of a lipid transfer protein syndrome

TLDR
WDEIA is a summation anaphylaxis, in which the patient only shows an allergic reaction when eating wheat-containing food in combination with trigger factors, e.

Wheat-dependent exercise-induced anaphylaxis with Tri-a-14-sensitization as part of a lipid transfer protein syndrome

TLDR
WDEIA is a summation anaphylaxis, in which the patient only shows an allergic reaction when eating wheat-containing food in combination with trigger factors, e.g. physical exercise, medical drugs or alcohol.

Series of 12 cases of wheat-dependent exercise-induced allergy in Aragon, Spain

Clinical features and outcomes of patients with wheat-dependent exercise-induced anaphylaxis: a retrospective study

TLDR
The diagnosis of WDEIA is frequently delayed, and approximately one-fifth of patients continue to experience anaphylaxis post-diagnosis, so patients must always carry epinephrine autoinjectors.
...

References

SHOWING 1-10 OF 120 REFERENCES

Food‐dependent exercise‐induced anaphylaxis: a case related to the amount of food allergen ingested

TLDR
A 24‐year‐old Japanese woman who suffered for 2 years from attacks of urticaria, dyspnoea and syncope associated with exercise after the ingestion of wheat was suspected to have food‐dependent exercise‐induced anaphylaxis caused by wheat.

Wheat-dependent exercise-induced anaphylaxis sensitized with hydrolyzed wheat protein in soap.

  • Y. ChinukiE. Morita
  • Medicine
    Allergology international : official journal of the Japanese Society of Allergology
  • 2012
TLDR
An increased incidence of a new subtype of WDEIA, which is likely to be sensitized via a percutaneous and/or rhinoconjunctival route to hydrolyzed wheat protein (HWP), has been observed, with the predominant observed symptom angioedema of the eyelids; a number of patients developed anaphylaxis.

Food-dependent exercise-induced anaphylaxis.

Food‐dependent exercise‐induced anaphylaxis: a report of two cases and determination of wheat‐γ‐gliadin as the presumptive allergen

Water/salt‐insoluble wheat proteins have been identified as the most frequent allergenic foodstuffs in patients with food‐dependent exercise‐induced anaphylaxis (FDEIA) in Japan. However, the…

Food‐dependent exercise‐induced anaphylaxis in childhood

TLDR
A diagnosis of FDEIA facilitates the safe independent return to exercise and reintroduction of foods for patients who otherwise may unnecessarily avoid exercise and/or restrict their diet.

Food‐dependent exercise‐induced anaphylaxis with a high level of plasma noradrenaline

TLDR
The tests showed no cross‐reactivity between the causative foods of OAS and FDEIA, indicating that the mechanisms of onset are different between them, and noradrenaline may be involved in the onset of FDEia.

Exercise and aspirin increase levels of circulating gliadin peptides in patients with wheat‐dependent exercise‐induced anaphylaxis

  • H. MatsuoK. Morimoto E. Morita
  • Medicine
    Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
  • 2005
TLDR
This work has shown that aspirin intake is a contributing factor in some patients with FDEIA, and the mechanism of eliciting the symptom in WDEIA remains not fully understood.

Gliadin-specific IgE in wheat-dependent exercise-induced anaphylaxis.

TLDR
All six WDEIA patients had high IgE binding signals to 50 kDa of gliadin extract on IgE immunoblots, and this binding was suppressed by SGF, although minimal inhibition was noted with SIF incubation.

[Food-dependent exercise-induced anaphylaxis].

  • M. Suko
  • Biology
    Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine
  • 2004
TLDR
In cases of wheat-dependent exercise-induced anaphylaxis, the IgE levels for ω 5-gliadin in a RAST were positive, and the patients had history of allergic disease such as atopic dermatitis, allergic rhinitis, and so on.

Wheat-dependent, Exercise-induced Anaphylaxis: A Successful Case of Prevention with Ketotifen.

TLDR
An interesting case of wheat-dependent, exercise-induced anaphylaxis with successful prevention by ketotifen is reported of a 20-year-old woman who had a 7-year history of recurrent wheals and dyspnea after ingesting several kinds of food along with physical exercise.
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