Three Cases of Wheat-dependent Exercise-induced Anaphylaxis Possibly Sensitized by Hydrolyzed Wheat Proteins in Soap

Abstract

We present three cases of wheat-dependent exercise-induced anaphylaxis (WDEIA) possibly sensitized by hydrolyzed wheat proteins (HWP) encountered by using HWP-supplemented soap. All three patients started to use the same brand of soap and subsequently developed contact urticaria several months later. They further developed WDEIA after having the contact urticaria. Skin prick tests revealed a positive reaction to diluted soap solution as well as to HWP. Serum IgE molecules reacting to HWP were detected by Western blotting using the patientsʼ sera. Physicians should be aware of the potential allergenicity of HWP, because HWP is being used more widely as a cosmetic supplement.