2017 Volume 31 Issue 5 Pages 683-691
Background : The patients with wheat allergy have cross-reactivity to barley. Since barley is served as barley rice and the like in daily life, we often need to decide whether they should avoid barley or not. However, factors predicting true barley allergy in patients with wheat allergy are not well-known.
Methods : Records of patients who undergone oral food challenge (OFC) with barley were retrospectively analyzed. They had been diagnosed as wheat allergy based on positive wheat OFC or recent history of wheat-induced anaphylaxis and had never taken barley. We sought possible associations between barley OFC outcome and symptoms/signs during wheat OFC, wheat and barley-specific IgE (sIgE).
Results : Twenty-seven patients (3-15 years old, M/F 19/8) undergone barley OFC and 13 (48%) were positive. We analyzed 23 patients with complete records of wheat OFC and sIgE. Ratio of the total score of anaphylaxis scoring Aichi (ASCA) and cumulative protein dose at wheat OFC, abbreviated as TS/Pro, was significantly higher in patients with positive barley OFC than those with negative OFC. Omega 5 gliadin and wheat sIgE were also significantly higher in positive barley OFC group.
Conclusions : Higher wheat TS/Pro, which indicates severe wheat allergy, higher sIgE to wheat and omega 5 gliadin may be factors to predict positive barley OFC in patients with wheat allergy.
