Clinical and laboratory features, and quality of life assessment in wheat dependent exercise-induced anaphylaxis patients from central China
- 1 June 2016
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Huazhong University of Science and Technology [Medical Sciences]
- Vol. 36 (3), 410-415
- https://doi.org/10.1007/s11596-016-1601-z
Abstract
Summary Wheat dependent exercise-induced anaphylaxis (WDEIA) is a rare but potentially severe food allergy caused by the combination of wheat ingestion and physical exercise. The impact of WDEIA on quality of life (QOL) is unclear. This study characterized the clinical and laboratory features and investigated the QOL in WDEIA patients from Central China. Twenty-eight WDEIA patients were analyzed, and QOL was measured by validated Chinese version Food Allergy Quality of Life Questionnaire-Adult Form (FAQLQ-AF) and Food Allergy Independent Measure (FAIM) after obtaining the diagnosis. The results showed that half of the patients were females. The median onset age was 37 years old. The symptoms occurred within 1 h after wheat ingestion (26/28). Symptoms of anaphylaxis included cutaneous (26/28), respiratory (11/28), gastro-intestinal (5/28) and cardiovascular manifestations (27/28). Skin prick tests were positive to salt soluble (89.3%) and salt insoluble wheat allergen extracts (100%). Positive rate to wheat, gluten and omega-5 gliadin specific IgE was 64.3%, 92.9% and 92.9% respectively. Specific IgE to omega-5 gliadin with a cut-off value 0.83 KU/L offered highly efficient diagnostic criterion for WDEIA (sensitivity: 89.3%; and specificity: 88.9%). The mean scores of FAQLQ-AF and FAIM were 4.70 and 4.98 respectively and level of anti-omega-5 gliadin IgE had positive correlations with FAQLQ scores. Thereby, WDEIA is commonly found in mid-age adults. In most cases, multi-organs especially skin and cardiovascular systems are involved. Salt insoluble wheat allergen skin test and serum specific IgE to gluten and omega-5 gliadin help to diagnose WDEIA. QOL in WDEIA patients is severely impaired.Keywords
This publication has 24 references indexed in Scilit:
- Diagnostic and experimental food challenges in patients with nonimmediate reactions to foodJournal of Allergy and Clinical Immunology, 2015
- Wheat-dependent exercise-induced anaphylaxis: a retrospective case review from a tertiary hospitalPublished by BMJ ,2014
- 2012 UpdateCurrent Opinion in Allergy and Clinical Immunology, 2012
- The Longest Wheal Diameter Is the Optimal Measurement for the Evaluation of Skin Prick TestsInternational Archives of Allergy and Immunology, 2009
- Wheat-dependent, exercise-induced anaphylaxis in Thai children: a report of 5 cases.2009
- Wheat allergyCurrent Opinion in Allergy and Clinical Immunology, 2009
- Impact of peanut allergy on quality of life, stress and anxiety in the familyAllergy, 2009
- Health-related quality of life in food hypersensitive schoolchildren and their families: parents' perceptionsHealth and Quality of Life Outcomes, 2006
- Significance and rationale of studies of health-related quality of life in anaphylactic disordersCurrent Opinion in Allergy and Clinical Immunology, 2006
- Food allergyThe Lancet, 2002