A Multicenter Evaluation of Diagnosis and Management of Omega-5 Gliadin Allergy (Also Known as Wheat-Dependent Exercise-Induced Anaphylaxis) in 132 Adults

The Journal of Allergy and Clinical Immunology. in Practice
Lucinda KennardAnnette Wagner

Abstract

Omega-5 gliadin allergy (also known as wheat-dependent exercise-induced anaphylaxis) is a rare allergy to wheat that often presents with intermittent severe anaphylaxis in the context of a cofactor, such as exercise. To undertake a detailed clinical characterization of the largest cohort of patients with omega-5 gliadin allergy to date. We retrospectively analyzed the demographic characteristics, presentation, investigation, and management of 132 patients presenting with omega-5 gliadin allergy in 4 UK centers. There were significant delays in diagnosis of 1 to 5 years (40% of patients) and more than 5 years (29% of patients). The commonest cofactors were exercise (80%), alcohol (25%), and nonsteroidal anti-inflammatory drugs (9%). A minority of patients (11%) had no identifiable cofactor. The level of specific IgE to omega-5 gliadin does not predict the severity of allergic reactions. Patients who adhered to a gluten-free diet and those who avoided wheat in combination with exercise achieved the largest reductions in subsequent allergic reactions of 67% and 69%, respectively. Omega-5 gliadin allergy is a rare wheat allergy that presents with severe anaphylaxis. The diagnosis is frequently delayed, and therefore we recommend th...Continue Reading

Citations

Jun 17, 2020·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·Krzyszof RutkowskiAnna Moniuszko-Malinowska
Oct 28, 2018·Current Allergy and Asthma Reports·Matthew P Giannetti
Feb 27, 2020·Asia Pacific Allergy·Philip Hei LiChak-Sing Lau
Mar 18, 2020·The World Allergy Organization Journal·UNKNOWN Steering Committee Authors, UNKNOWN Review Panel Members
Feb 20, 2021·The Application of Clinical Genetics·Nastaran AsriKamran Rostami
Apr 9, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Magdalena KraftMargitta Worm
Apr 29, 2021·Journal of Asthma and Allergy·Celia ZubrinichMark Hew
Apr 26, 2021·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Lukasz BlazowskiJoanna Jerzynska

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