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Allergy to ingested cereals in atopic children

  1. L. Räsänen1,2,*,
  2. M. Lehto1,
  3. K. Turjanmaa2,
  4. J. Savolainen3,
  5. T. Reunala2

Article first published online: 28 APR 2007

DOI: 10.1111/j.1398-9995.1994.tb00790.x

Issue

Allergy

Allergy

Volume 49, Issue 10, pages 871–876, December 1994

Additional Information

How to Cite

Räsänen, L., Lehto, M., Turjanmaa, K., Savolainen, J. and Reunala, T. (1994), Allergy to ingested cereals in atopic children. Allergy, 49: 871–876. doi: 10.1111/j.1398-9995.1994.tb00790.x

Author Information

  1. 1

    Department of Clinical Medicine, University of Tampere

  2. 2

    Department of Dermatology, Tampere University Hospital

  3. 3

    Department of Medical Microbiology, University of Turku, Finland

*Dr Liisa Räsänen Department of Clinical Medicine University of Tampere Box 607 FIN-33101 Tampere 10 Finland

Publication History

  1. Issue published online: 28 APR 2007
  2. Article first published online: 28 APR 2007
  3. Accepted for publication 4 June 1994

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Keywords:

  • cereals;
  • food allergy;
  • gliadin;
  • histamine-release test;
  • lymphocyte-proliferation test;
  • skin tests

Clinical features, hypersensitivity mechanisms, and differential diagnosis of cereal allergy or intolerance were investigated in children with atopic dermatitis (AD). On oral provocation, 18 children exhibited a positive response to wheat, three to rye, one to barley, and one to oats. Cereal-induced symptoms were dermatologic, gastrointestinal, or oropharyngeal, and their onset after provocation was immediate (eight cases), delayed (14 cases), or both immediate and delayed (one case). A combination of type I allergy tests (prick test, RAST, and histamine-release test) detected all immediate reactors and 9/14 delayed reactors. Of the five subjects remaining negative in these tests, three were positive in the patch or lymphocyte-proliferation tests. Subjects with cereal allergy or intolerance frequently possessed IgE, IgA, and IgG antibodies against gliadin, but only one of these children was HLA-DR3-positive, and none had reticulin antibodies typical of celiac disease. Combining tests of immediate and delayed hypersensitivity can confirm allergy to cereals in a more reliable way. The coexistence of cereal allergy and celiac disease seems to be rare.

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