Age of resolution from IgE-mediated wheat allergy

• Published in: Asian Pacific journal of allergy and immunology Vol. 35; no. 2; pp. 113 - 117
• Main Authors: Siripipattanamongkol, Nunthana, Vichyanond, Pakit, Jirapongsananuruk, Orathai, Veskitkul, Jittima, Visitsunthorn, Nualanong, Pacharn, Punchama
• Format: Journal Article
• Language: English
• Published: Thailand The Allergy and Immunology Society 01.06.2017
• Subjects: Age; Allergies; Children; Children & youth; Food allergies; Gliadin; Immunoglobulin E; Skin tests; Wheat
• ISSN: 0125-877X
• DOI: 10.12932/AP0768

The natural history of wheat allergy varies among different countries. To study the age of resolution from IgE-mediated wheat allergy and to define the predictors of wheat tolerance. Patients with a history of immediate reactions after wheat ingestion were enrolled. Skin prick test (SPT) and measurement of serum specific IgE (sIgE) to wheat and ω-5 gliadin were performed. Oral challenge to wheat was performed to determine wheat tolerance. Fifty-five patients, aged 6 months to 12 years, were studied. The median age of wheat tolerance was 76 months (range 37-114 months). The percentage of children with wheat tolerance was 14.7% at age 2 years, 27% by age 4, 45.7% by age 5 and 69% by age 9. Predictors for wheat tolerance were SPT for wheat less than 3 mm of wheal diameter (hazard ratio 8.9), sIgE levels of wheat and ?-5 gliadin less than 0.35 (HR 4.3) and 0.35 kAU/L (HR 44), respectively, duration of onset of symptoms to time of physician diagnosis less than 36 months (HR 7.6) and no history of allergic rhinitis (HR 4.8). Forty percent of children with IgE-mediated wheat allergy develop tolerance by the age of 5 years. Size of SPT, IgE level of wheat and ω-5 gliadin, time from onset of symptoms to physician diagnosis and history of allergic rhinitis are helpful for predicting wheat tolerance.