{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:03:39Z","timestamp":1765724619542,"version":"3.48.0"},"reference-count":20,"publisher":"BMJ","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2010,5,24]]},"published-print":{"date-parts":[[2010,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The presentation of wheat dependent exercise induced anaphylaxis (WDEIA) can be variable. A high index of clinical suspicion is required to initiate the investigation pathway. Double blind placebo controlled food-exercise challenge is the gold standard investigation but the practicality of this test limits its application.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To critically analyse the symptoms of WDEIA and their correlation with serum specific IgE (sIgE) to r\u03c9-5-gliadin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>17 patients were tested for serum sIgE to r\u03c9-5-gliadin. The clinical response to a diet\/exercise intervention protocol was used to assess specificity of a positive sIgE to r\u03c9-5-gliadin. Length of time to diagnosis, clinical likelihood scores, exercise intensity involved and the severity of allergic reactions were examined retrospectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>8\/10 patients with positive sIgE to r\u03c9-5-gliadin had a confirmed diagnosis of WDEIA. Half of the WDEIA patients had a prolonged time lag to diagnosis (32\u201362 months) and were initially diagnosed with idiopathic anaphylaxis or chronic idiopathic urticaria and angioedema. Only three patients had experienced life threatening symptoms (Mueller grading 4). A close association was observed between requirements of lower exercise intensity to provoke a reaction and diagnostic delay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Specific IgE to r\u03c9-5-gliadin can provide supportive evidence for WDEIA without the need of a food-exercise challenge. The wheat-exercise association is not obvious in many patients, highlighting the need to consider WDEIA in the differential diagnosis of all patients presenting with idiopathic systemic reactions. The term anaphylaxis may be inappropriate and it is therefore worth considering an alternative terminology such as \u2018activity dependent wheat allergy\u2019 to describe this condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jcp.2010.078808","type":"journal-article","created":{"date-parts":[[2010,8,9]],"date-time":"2010-08-09T21:55:37Z","timestamp":1281390937000},"page":"814-817","source":"Crossref","is-referenced-by-count":32,"title":["Wheat dependent exercise induced anaphylaxis: is this an appropriate terminology?"],"prefix":"10.1136","volume":"63","author":[{"given":"G K Y","family":"Wong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A P","family":"Huissoon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Goddard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D M","family":"Collins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M T","family":"Krishna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2010,8,9]]},"reference":[{"key":"2025121406590579000_63.9.814.1","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0b013e32832aa5bc"},{"key":"2025121406590579000_63.9.814.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2005.02213.x"},{"key":"2025121406590579000_63.9.814.3","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.2002.23836_12.x"},{"key":"2025121406590579000_63.9.814.4","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2001.04329.x"},{"key":"2025121406590579000_63.9.814.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2007.00599.x"},{"key":"2025121406590579000_63.9.814.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(99)70438-0"},{"key":"2025121406590579000_63.9.814.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0923-1811(03)00156-7"},{"key":"2025121406590579000_63.9.814.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-4658.2005.04858.x"},{"key":"2025121406590579000_63.9.814.9","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1111\/j.1398-9995.2007.01504.x","article-title":"Sensitivity and specificity of recombinant omega-5 gliadin-specific IgE measurement for the diagnosis of wheat-dependent exercise-induced anaphylaxis","volume":"63","author":"Matsuo","year":"2008","journal-title":"Allergy"},{"key":"2025121406590579000_63.9.814.10","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.175.12.8116"},{"key":"2025121406590579000_63.9.814.11","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2001.118602"},{"key":"2025121406590579000_63.9.814.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2008.01753.x"},{"key":"2025121406590579000_63.9.814.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2008.06.006"},{"issue":"Suppl 83","key":"2025121406590579000_63.9.814.14","first-page":"p370","article-title":"Utilization of the recombinant HMWglutenin for diagnosis of wheat-dependent exercise induced anaphylaxis (abstract)","volume":"62","author":"Takahashi","year":"2007","journal-title":"Allergy"},{"key":"2025121406590579000_63.9.814.15","unstructured":"Working Group of Resuscitation Council (UK). 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