{"title":"成分解析诊断在儿童小麦依赖运动诱发的过敏反应:一个病例报告。","authors":"Manabu Miyamoto, Nobuyuki Maruyama, Shigemi Yoshihara","doi":"10.15586/aei.v53i4.1316","DOIUrl":null,"url":null,"abstract":"<p><p>Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a subtype of immunoglobulin E (IgE)-mediated wheat allergy characterized by symptoms from wheat intake followed by physical exercise. Although omega-5 gliadin-specific IgE (sIgE) is widely used for diagnosing WDEIA, its sensitivity is lower in children than in adults. This report describes a 13-year-old male with suspected wheat allergy who experienced anaphylaxis following wheat ingestion and exercise. ImmunoCAP results revealed positive sIgE for wheat and gluten but negative results for omega-5 gliadin. An open-label oral food challenge combined with exercise confirmed the diagnosis of WDEIA. Notably, alpha/beta gliadin sIgE was detected using an enzyme-linked immunosorbent assay with the patient's serum, suggesting that alpha/beta gliadin can serve as an alternative marker in pediatric cases where omega-5 gliadin sIgE is undetectable. This suggests that omega-5 gliadin sIgE alone may not be appropriate for diagnosing WDEIA in children. Instead, utilizing a combination of other wheat protein components may enhance both sensitivity and specificity in diagnosis.</p>","PeriodicalId":7536,"journal":{"name":"Allergologia et immunopathologia","volume":"53 4","pages":"138-140"},"PeriodicalIF":2.1000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Component-resolved diagnostics in pediatric wheat-dependent exercise-induced anaphylaxis: A case report.\",\"authors\":\"Manabu Miyamoto, Nobuyuki Maruyama, Shigemi Yoshihara\",\"doi\":\"10.15586/aei.v53i4.1316\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a subtype of immunoglobulin E (IgE)-mediated wheat allergy characterized by symptoms from wheat intake followed by physical exercise. Although omega-5 gliadin-specific IgE (sIgE) is widely used for diagnosing WDEIA, its sensitivity is lower in children than in adults. This report describes a 13-year-old male with suspected wheat allergy who experienced anaphylaxis following wheat ingestion and exercise. ImmunoCAP results revealed positive sIgE for wheat and gluten but negative results for omega-5 gliadin. An open-label oral food challenge combined with exercise confirmed the diagnosis of WDEIA. Notably, alpha/beta gliadin sIgE was detected using an enzyme-linked immunosorbent assay with the patient's serum, suggesting that alpha/beta gliadin can serve as an alternative marker in pediatric cases where omega-5 gliadin sIgE is undetectable. This suggests that omega-5 gliadin sIgE alone may not be appropriate for diagnosing WDEIA in children. Instead, utilizing a combination of other wheat protein components may enhance both sensitivity and specificity in diagnosis.</p>\",\"PeriodicalId\":7536,\"journal\":{\"name\":\"Allergologia et immunopathologia\",\"volume\":\"53 4\",\"pages\":\"138-140\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Allergologia et immunopathologia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.15586/aei.v53i4.1316\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Allergologia et immunopathologia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.15586/aei.v53i4.1316","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ALLERGY","Score":null,"Total":0}
Component-resolved diagnostics in pediatric wheat-dependent exercise-induced anaphylaxis: A case report.
Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a subtype of immunoglobulin E (IgE)-mediated wheat allergy characterized by symptoms from wheat intake followed by physical exercise. Although omega-5 gliadin-specific IgE (sIgE) is widely used for diagnosing WDEIA, its sensitivity is lower in children than in adults. This report describes a 13-year-old male with suspected wheat allergy who experienced anaphylaxis following wheat ingestion and exercise. ImmunoCAP results revealed positive sIgE for wheat and gluten but negative results for omega-5 gliadin. An open-label oral food challenge combined with exercise confirmed the diagnosis of WDEIA. Notably, alpha/beta gliadin sIgE was detected using an enzyme-linked immunosorbent assay with the patient's serum, suggesting that alpha/beta gliadin can serve as an alternative marker in pediatric cases where omega-5 gliadin sIgE is undetectable. This suggests that omega-5 gliadin sIgE alone may not be appropriate for diagnosing WDEIA in children. Instead, utilizing a combination of other wheat protein components may enhance both sensitivity and specificity in diagnosis.
期刊介绍:
Founded in 1972 by Professor A. Oehling, Allergologia et Immunopathologia is a forum for those working in the field of pediatric asthma, allergy and immunology. Manuscripts related to clinical, epidemiological and experimental allergy and immunopathology related to childhood will be considered for publication. Allergologia et Immunopathologia is the official journal of the Spanish Society of Pediatric Allergy and Clinical Immunology (SEICAP) and also of the Latin American Society of Immunodeficiencies (LASID). It has and independent international Editorial Committee which submits received papers for peer-reviewing by international experts. The journal accepts original and review articles from all over the world, together with consensus statements from the aforementioned societies. Occasionally, the opinion of an expert on a burning topic is published in the "Point of View" section. Letters to the Editor on previously published papers are welcomed. Allergologia et Immunopathologia publishes 6 issues per year and is included in the major databases such as Pubmed, Scopus, Web of Knowledge, etc.