Better management of wheat allergy using a very low-dose food challenge: A retrospective study.
BACKGROUND
Low-dose reactive wheat-allergic children are at a high risk of a positive oral food challenge (OFC). The present study aimed to evaluate whether the results of a very low-dose (VL) OFC would contribute to better wheat allergy management in this population.


METHODS
We retrospectively reviewed wheat-allergic subjects who underwent a VL OFC with 2 g of udon noodles (equivalent to 53 mg of wheat protein) and had a previous allergic reaction to <15 g of udon noodles (equivalent to 400 mg of wheat protein) within 2 years before the OFC. Subjects who passed the OFC were defined as VL tolerant; those who failed were considered VL reactive. In VL tolerant subjects, the dose was increased to 15 g of udon noodles either during an OFC in our hospital or gradually at home.


RESULTS
Of the 57 included subjects (median age, 2.9 years; range, 1.0-11.8 years), 32 (56%) were VL tolerant and 25 (44%) were VL reactive. Most reactions during the OFC could be treated with an antihistamine and/or a nebulized β2 agonist. VL tolerant subjects consumed 2 g of udon noodles or a seasoning containing wheat. Within a year after the OFC, 18 VL tolerant subjects (56%), but no VL reactive subjects, were able to consume 15 g of udon noodles (p < 0.001).


CONCLUSIONS
A VL OFC can shift the management of some low-dose reactive wheat-allergic children from complete avoidance to partial wheat intake.
['Okada|Yu|Y|', 'Yanagida|Noriyuki|N|', 'Sato|Sakura|S|', 'Ebisawa|Motohiro|M|']
D000485:Allergens D003888:Desensitization, Immunologic D019468:Disease Management D005260:Female D005500:Follow-Up Studies D006801:Humans D007073:Immunoglobulin E D007223:Infant D008297:Male D012189:Retrospective Studies D016896:Treatment Outcome D021182:Wheat Hypersensitivity
Disease management Food allergy Food hypersensitivity Specific IgE Wheat hypersensitivity