Articles
 

Follow-Up of the Wheat Allergy in Children; Consequences and Outgrowing the Allergy

Abstract

Allergy to wheat is a common food allergy. In spite of this fact, there is not enough literature regarding the features and outgrowing of this allergy. The objective of this study was to evaluate the manifestations of this allergy and to follow the patients to evaluate whether outgrowing allergy happens again and when it occurs.
Eight wheat allergic patients diagnosed between 2000 and 2001 were re-evaluated together  with 13 other  new cases of  wheat allergy referred to  the  Immunology and Allergy Pediatric  Department   from  June  2004  to  March  2006.  For  all  cases,  the demographic data along with a complete history regarding allergy to wheat and other types of allergy were collected in questionnaires. The specific IgE measurements (in vivo and in vitro) and oral food challenge (in the absence of a relevant history related to allergy to wheat) were performed.
Severe anaphylaxis was seen after wheat ingestion in more than 90% of the patients. Oral tolerance to wheat developed in three patients (37.5%) out of 8 known previous cases who had been followed for eight years, the mean age of oral tolerance to wheat was 68±6.36 (range; 36 months to 108 months).
Clinical reactions in our wheat-allergic patients were more severe than those reported before. These patients were at risk for developing chronic allergic symptoms such as asthma. We also found that oral tolerance to wheat was happening in a minority of our patients.

1. Sampson HA. Utility of food-specific IgE concentration in predicting symptomatic food allergy. J Allergy Clin Immunol 2001; 107(5):891-896.
2. Kanny G, Moneret-Vautrin DA, Flabbee J, Beaudouin E ,Morisset M. Population Study of food allergy in France. J Allergy Clin Immunol 2001; 108(1):133-140.
3. Niggemann B, Reible S, Wahn U. The atopy patch test (APT)-a useful tool for the diagnosis of food allergy in children with atopic dermatitis. Allergy 2000; 55(3):281-5.
4. Burks A.W, James JM, Hiegel A, Wilson G, Wheeler JG, Jones SM, et al. Atopic dermatitis and food hypersensitivity reactions. J Pediatr 1998; 132(1):132-6.
5. Rance F and Bidat E. Toutes les allergies alimentaires ne se ressemblent pas. in: Rance F, Bidat E, Editors .Allergie alimentaire chez l’enfant. Geneve : Medicine & hygiene,2000:114-5.
6. Battais F, Mothes T, Moneret-Vautrin DA, Pineau F, Kanny G, Pineau Y, et al. Identification of IgE-binding epitopes on gliadins for patients with food allergy to wheat. Allergy 2005; 60(6):815-21.
7. Beyer K, Bardina L, Sampson H. Difference in recognition of water soluble and insoluble wheat allergens in two varieties of wheat flour between wheat allergic and wheat-sensitized but clinically tolerant patients. J allergy Clin Immunol 2005; 115(2):245.
8. Battais F, Richard C, Leduc V. Les allergènes du grain de blé (wheat grain allergens). Revue Française d'Allergologie et d'Immunologie Clinique 2007;47(3):171-4.
9. Palosuo K, Varjonen E, Kekki OM, Klemola T, Kalkkinen N, Alenius H, et al. Wheat ω-5 gliadin is a major allergen in children with immediate allergic reaction to ingested wheat. J Allergy Clin Immunol 2001;108(4):634-8.
10. Boissieu D.de, Dupont C. Dermatite atopique de l’enfant et allergie au blé. Revue française d’allergologie et d’immunologie clinique 2005; 45(5):411-5.
11. Scibilia J, Pastorello EA, Zisa G, Ottolenghi A, Bindslev-Jensen C, Pravettoni V, et al. Wheat allergy: A double- blind , Placebo-controlled study in adults. J Allergy Clin Immunol 2006; 117(2):433-9.
12. Sampson HA. Immediate hypersensitivity reactions to food : blinded food challenges in children with atopic dermatitis. Ann Allergy 1986; 57(3):209-12.
13. Bock SA. A critical evaluation of clinical trials in adverse reactions to foods in children. J allergy Clin Immunol 1986; 78(1 pt 2):165-74.
14. Majamaa H, Moisio P, Holm K, Tourjanmaa K. Wheat allergy :diagnostic accuracy of skin prick and patch tests and specific IgE. Allergy 1999; 54(8):851-6.
15. Varjonen E, Vainio E, Kalmio K. Antigliadin. IgE :indicator of wheat allergy in atopic dermatitis. Allergy 2000; 55(4):386-91.
16. Pourpak Z, Mansouri M, MesdaghiM, Kazemnejad A, Farhoudi A. wheat allergy; clinical and laboratory findings. Int Arch allergy immunol 2004; 133(2):168-73.
17. Jones SM, Magnolfi CF, Cooke SK, Sampson HA.Immunologic cross-reactivity among cereal grains and grasses in children with food hypersensitivity. J Allergy Clin Immunol 1995; 96(3):341–51.
18. Bindslev-Jensen C, Ballmer-Weber BK, Bengtsson U, Blanco C, Ebner C,Hourihane J. Standardization of food challenges in patients with immediate reactions to foods- position paper from the European Academy of Allergology and Clinical Immunology. Allergy 2004;59(7):690–7.
19. Sampson HA. Anaphylaxis and Emergency& Treatment.Pediatrics 2003; 111(6 Pt 3):1601-8.
20. Rancé F, Deschildre A. Test de provocation par voie orale aux aliments chez l’enfant. Quand, pour qui et comment? Introduction, définitions glossary. Rev Fr Allergol Immunol Clin 2006; 46:604–82.
21. Sampson HA. Anaphylaxis and Emergency& Treatment.Pediatrics 2003; 111(6 Pt 3):1601-8.
22. Taylor SL, Hefle SL. foods as allergens. In: Brostoff J, Challacombe SJ, editors. food allergy and intolerance. Philadelphia :Saunders, 2002:403-12.
23. Saadon-Cousin C, Paty E, Scheinmann P. Allergie au blé (wheat flour allergy). Revue française d’allergologie et d’immunologie clinique 2002; 42(6):583-94.
24. Hischenhuber C, Crevel R, Jarry B, Maki M, Monter Vautrin D.A, Romano A, et al. Review article: Safe amount of gluten for patients with wheat allergy or celiac disease. Alimen Pharmacol Ther 2006; 23(5):559-75.
25. Skripak JM, Sampson HA. Towards a cure for food allergy Current Opinion in Immunology 2008; 20(6):690-6.
26. Gaffin J M. Peanut Allergy is Associated with Increased Asthma Prevalence in Food Allergic Children. J Allergy Clin Immunology 2009; 123(2):S110.
27. Schroede Ar, Kumar A, Sullivan C L, Vucic Y, Caruso D M, Costello J, et al. Associations and Temporal Relationship between food allergy and asthma J J Allergy Clin Immunology 2008; 121(2):S236.
28. Poole JA, Barriga K, Leung DY, Hoffman M, Eisenbarth GS, Rewers M, et al. Timing of initial exposure to cereal grains and the risk of wheat allergy Pediatrics 2006;117(6):2175–82.
29. Pourpak Z, Mesdaghi M, Mansouri M, Kazemnejad A, Toosi SB , Farhoudi A. Which cereal is a suitable substitute for wheat in children with wheat allergy. Pediatric Allergy & Immunology 2005; 16(3):262-5.
30. Keet CA, Matsui EC, Dhillon G, Lenehan P, Paterakis M, Wood RA. The natural history of wheat allergy Ann Allergy Asthma Immunol 2009; 102(5):410-5.
31. Skripak JM, Matsui EC, Mudd K, Wood RA. The natural history of IgE-mediated cow’s milk allergy. J Allergy Clin Immunol 2007; 120(5):1172-7.
32. Fleischer DM, Conover-Walker MK, Matsui EC, Wood RA. The natural history of tree nut allergy. J Allergy Clin Immunol. 2005; 116(5):1087–93.
33. Fleischer DM, Conover-Walker MK, Christie L, Burks AW, Wood RA. The natural progression of peanut allergy: resolution and the possibility of recurrence. J Allergy Clin Immunol 2003; 112(1):183–9.
34. Savage JH, Matsui EC, Skripak JM, Wood RA. The natural history of egg allergy. J Allergy Clin Immunol 2007; 120(6):1413–7.
35. Sampson HA, Scanlon SM. Natural history of food hypersensitivity in children with atopic dermatitis. J Pediatr 1989; 115(1):23–7.
36. Sampson HA, McCaskill CC. Food hypersensitivity and atopic dermatitis: evaluation of 113 patients. J Pediatr 1985; 107(5):669–75.
37. Moneret-Vautrin AAD, Moneret-Vautrin AD .Wheat Allergy: A prospective study in children and adults, with reference to celiac disease. J Allergy Clin Immunol FEB 2004; 113(2): S150.

Files
IssueVol 11, No 2 (2012) QRcode
SectionArticles
Keywords
Anaphylaxis IgE mediated hypersensitivity Oral tolerance Wheat allergy

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Mansouri M, Pourpak Z, Mozafari H, Abdollah Gorji F, Shokouhi Shoormasti R. Follow-Up of the Wheat Allergy in Children; Consequences and Outgrowing the Allergy. Iran J Allergy Asthma Immunol. 1;11(2):157-163.