Diagnosis of wheat allergy

IgE mediated wheat allergy

Clinicians are faced with reported wheat/gluten related intolerances on a regular basis, with little evidence about the usefulness of current skin prick tests (SPT) and specific IgE tests in the diagnostic work-up of IgE mediated wheat allergy. Skin prick tests and/or specific IgE tests alongside a good clinical history or food challenge are used as the mainstay for the diagnosis of wheat allergy. However, a number of studies have recently been published on the diagnostic usefulness of component resolved diagnostics in the diagnosis of wheat allergy, indicating that these may be useful tests [1] in distinguishing those with true wheat allergy.

Non-IgE mediated wheat allergy

The diagnosis of non-IgE mediated wheat allergy is more complex with a lack of any validated test. The only way of diagnosing non-IgE mediated wheat allergy is to avoid the offending food (usually for a period of between 2-6 weeks) with a monitored reintroduction of the food. Depending on the underlying pathology and severity of past reactions, this reintroduction could be carried at home or in a clinical setting.