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… 

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.

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.

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.
...

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