Wheat-induced anaphylaxis

Abstract

A 13 year old boy suffered two separate episodes of severe anaphylaxis after consuming sandwiches and a piece of bread. Prick skin testings with available food allergens only revealed a positive reaction to a 1:10 w/v of wheat flour extract. A diagnosis of wheat-induced anaphylaxis was made and a double blind food challenge was suggested however was declined by the family. The patient was instructed to avoid all wheat containing foods and to carry a kit containing an epinephrine pre-loaded syringe and an antihistamine tablet to be used in the event of inadvertant consumption with an instruction to seek medical assistance as soon as possible. Thus far, no further recurrence of anaphylaxis was encountered. A review of the current literature discloses that wheat-induced anaphylaxis is an uncommon event and could occur either immediately after the ingestion or with a concomitant exercise. The natural history of wheat allergy is currently not fully understood but may possibly be a life long event.