2004 Volume 114 Issue 9 Pages 1535-1538
A 61-year-old Japanese man, who visited our clinic in April 4 2003, had suffered from occasional attacks of urticaria and anaphylactic shock associated with exercise after the ingestion of wheat for one year. Blood examination revealed that his total serum IgE was 44.5 IU/ml, RAST (Index) was 2.3 for wheat, and 2.3 for gluten. The challenge test with exercise following ingestion of wheat noodles (120 g) induced generalized urticaria and shock. The diagnosis of wheat-dependent exercise-induced anaphylaxis was made. A significant amount of gliadin was detected in his serum in parallel with symptoms during the challenge test of wheat noodles combined with exercise. However, serum gliadin was not detected after the ingestion wheat noodles alone. We concluded that the exercise induces the absorption of wheat allergen from the gut, resulting in the appearance of symptoms in the patient.
