Abstract
Abstract Rationale This study aims to the comparison of clinical pictures in children and in adults, the efficiency of an oral tolerance protocol in children, and a search for specific criteria of celiac disease. Predictive values of skin tests and specific IgE levels are searched for. Methods Prick-in-prick tests, RAST, SBPCFC to wheat and gluten, CD specific serology HLA-typing, were carried out in 38 children and 41 adults selected from a population of 326 children and 164 adults with confirmed food allergy, on the basis of suspected WA. After a period of gluten-free diet a second SBPCFC was done, then an oral tolerance protocol (OTP) was implemented in children. The subsequent follow-up used a telephone survey. Results The prevalence of WA was 11,6% of food allergies in children, 25% of FA in adults. Main symptoms were atopic dermatitis in children (36/38), exercise-induced WA (11) and chronic urticaria (CU) (13) in adults. Recovery was achieved in a mean time of 2 years in 57,9% of children, 26,3% of adults. No PPV values for PIP and specific IgEs were obtained. Threshold doses of wheat flour were globally higher than those considered risk levels for CD, since only 11,4% of children, 2,8% of adults reacted to less than 100 mg of gluten. Conclusions WA and CD are distinct diseases. Clinical features vary according to the age. Wheat induced CU in adults is highlighted. A wheat starch based diet could be safe. WA in children is significantly associated with the HLA DR1 allele.
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