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.