Age of resolution from IgE-mediated wheat allergy.

Background: Wheat allergy is common in children. The natural history of wheat allergies varies among different countries. Objective: To study the age of resolution from IgE-mediated wheat allergy and to define the predictors of wheat tolerance. Method: Patients with a history of immediate reactions after wheat ingestion were included in this study. Skin prick tests (SPTs) and measurement of serum-specific IgE (sIgE) to wheat and w-5 gliadin was performed. An oral challenge to wheat was performed to determine wheat tolerance. Results: Fifty-five patients aged between 6 months and 12 years were included in this study. The median age for development of wheat tolerance was found to be 76 months (range 37-114 months). The proportion of children with wheat tolerance was 14.7% by 2 years of age, 27% by 4 years, 45.7% by 5 years and 69% by 9 years of age. An independent predictor for wheat tolerance was sIgE levels against w-5 gliadin of less than 0.35 kAU/L (adjusted hazard ratio 5.7; 95% CI 1.2-26.8). Conclusions: Of the children with IgE-mediated wheat allergy included in this study, 45.7% developed tolerance by 5 years of age. The concentration of sIgE for w-5 gliadin is helpful for predicting wheat tolerance.