Anaphylaxis after wheat ingestion in a patient with coeliac disease: two kinds of reactions and the same culprit food.

Authors:
Maurizio Mennini
Maurizio Mennini
Sapienza University of Rome
Italy
Alessandro Fiocchi
Alessandro Fiocchi
Pediatric Hospital Bambino Gesù
United States
Federica Ferrari
Federica Ferrari
Laboratory of Pharmacology and Molecular Medicine of Central Nervous System
Donatella Iorfida
Donatella Iorfida
University of Pavia
Italy
Salvatore Cucchiara
Salvatore Cucchiara
Sapienza University of Rome
Italy
Monica Montuori
Monica Montuori
Sapienza University of Rome
Italy

Eur J Gastroenterol Hepatol 2019 Apr 15. Epub 2019 Apr 15.

Pediatric Gastroenterology and Liver Unit, Department of Pediatrics, Sapienza University of Rome, Rome, Italy.

In recent years, the role of atopic dermatitis epidermal skin barrier defects in inducing a transcutaneous allergic sensitization is highly debated, possibly explaining why some children with eczema are sensitized to foods they have never eaten. In our specific situation, the association between coeliac disease and wheat allergy might be particularly harmful owing to unavoidable strict food avoidance. We describe the case of a young boy affected by coeliac disease who, after an occasional unexpected ingestion of gluten, experienced a complete anaphylactic reaction characterized by urticarial, labial angioedema, wheezing, and hypotension. To better investigate the state of allergic sensitization to wheat in our patient, we then performed the component resolved diagnosis, which showed Tri a19 2 kU/l and Tri a14 0.3 kU/l. These results demonstrated the association of IgE-mediated allergy to wheat and coeliac disease. The natural course of specific IgE in allergic patients who are on a food-free diet needs further investigation, such as the possible influence that the increasing popularity of gluten-free diets may have on the epidemiology of wheat allergy in westernized societies. National and International registers of cases of anaphylaxis may improve the still limited knowledge in this field. The final message of our contribution is that the decision to eliminate a food should to take into account a patient's awareness of possible consequences.

Download full-text PDF

Source
http://dx.doi.org/10.1097/MEG.0000000000001421DOI Listing
April 2019
3 Reads

Publication Analysis

Top Keywords

coeliac disease
16
wheat allergy
8
allergic sensitization
8
resolved diagnosis
4
diagnosis tri
4
component resolved
4
patient performed
4
state allergic
4
sensitization wheat
4
wheat patient
4
performed component
4
a19 2 ku/l
4
demonstrated association
4
association ige-mediated
4
ige-mediated allergy
4
03 ku/l demonstrated
4
a14 03 ku/l
4
investigate state
4
2 ku/l tri
4
tri a14
4

Similar Publications