Recently, Kennard et al . reported 132 adult WDEIA patients in 4 UK centers diagnosed based on a clinical history compatible with allergic reactions after wheat consumption and with positive omega-5 gliadin specific IgE without performing food exercise challenge test. Therefore, we aimed to establish a new diagnosis criteria and management of this common but life-threatening disorder.
Confirmed anaphylactic reactions triggered by wheat with positive sIgE response to ?-5-gliadin or gluten can provide supporting evidence for clinicians to make the diagnosis with no food exercise challenge test. Efforts to raise clinical awareness, and use of these targeted sIgE tests, will be valuable for the diagnosis and management of this condition.
FEV1 values were measured after the exercise challenge test. In fact, we have found a significant decrease in FEV1 only at 5 minutes post exercise in footballers and judokas (P = 0.032 < 0.05).
This was the greatest decline of FEV1 among the groups at all times (5, 10, and 15 minutes after the exercise challenge test).
However, the degree of EIB of pre-pubertal boys in Football is higher than that in Judo and control groups, especially after 5 minutes of the exercise challenge test, after that the degree of EIB decreases at 10 and 15 minutes.
Each of the three identified trials found that vitamin C halved the FEV1 decline caused by exercise challenge test
. The pooled estimate of vitamin C effect indicated a 48 percent reduction in the FEV1 decline caused by exercise.
Exercise challenge test
: Is a 15% fall in [FEV.sub.1] sufficient for diagnosis?
If there was no response to bronchodilator, or if the test was deemed normal, patients were scheduled for an exercise challenge test
, using a standard treadmill exercise protocol.
EIA/EIB can often be diagnosed with an exercise challenge test
(in which a reduction of pulmonary function by at least 15% is diagnostic), a eucapnic voluntary hyperventilation challenge (the preferred method used by the International Olympic Committee), a pharmacologic challenge, or an osmotic challenge.
Field exercise challenge test is performed in the sport, in which athletes are normally engaged.
Laboratory exercise challenge test considers more factors than methacholine test, but the disadvantage of this test is that it can only be performed on a treadmill or cycle ergometer.
There are two types of exercise tests; laboratory exercise challenge tests and field exercise challenge tests.