loading page

Exercise-induced allergic reactions after achievement of desensitization to cow's milk and wheat
  • +3
  • Shohei Kubota,
  • Katsumasa Kkitamura,
  • Teruaki Matsui,
  • Yoshihiro Takasato,
  • Shiro Sugiura,
  • Komei Ito
Shohei Kubota
Aichi Children's Health and Medical Center
Author Profile
Katsumasa Kkitamura
Aichi Children's Health and Medical Center
Author Profile
Teruaki Matsui
Aichi Children's Health and Medical Center
Author Profile
Yoshihiro Takasato
Aichi Children's Health and Medical Center
Author Profile
Shiro Sugiura
Aichi Children's Health and Medical Center
Author Profile
Komei Ito
Aichi Children's Health and Medical Center
Author Profile

Abstract

Background: We have previously reported that more than half of the patients who achieved desensitization after wheat rush oral immunotherapy (OIT) developed exercise-induced allergic reaction on desensitization (EIARD). However, data on EIARDs after slow OIT are lacking. Therefore, this study aimed to investigate the results of exercise provocation tests (EPTs) in patients after slow OIT for cow’s milk and wheat allergies. Methods: This was a retrospective chart review of 87 EPTs in 74 patients. The EPTs were performed in patients who were desensitized to at least 6,600 mg cow’s milk protein or 5,200 mg wheat protein with slow OIT and were identified to be at a high risk of EIARDs. EPTs were performed after ingestion of the maximum desensitization dose. The patients’ clinical characteristics and symptoms were analyzed. Results: The EPT results were positive for cow’s milk in 49% (21/43) of the patients and for wheat in 48% (15/31) of the patients. There was no significant difference in the clinical characteristics between the EIARD-positive and EIARD-negative groups. The specific IgE (sIgE) levels before OIT and the reduction rates of sIgE before and after OIT did not correlate with the outcomes of the EPTs. Among the EIARD-positive patients, 13 patients (cow’s milk, n=7; wheat, n=6) underwent a second EPT, and the EIARD disappeared in 8 patients (cow’s milk, n=4; wheat, n=4). Conclusion: EIARDs were observed after slow OIT for cow’s milk and wheat. Further research into the predictive factors of EIARDs in these patients is needed to understand its clinical manifestations.

Peer review status:Published

18 Oct 2020Submitted to Pediatric Allergy and Immunology
24 Oct 2020Reviewer(s) Assigned
10 Nov 2020Review(s) Completed, Editorial Evaluation Pending
18 Nov 2020Editorial Decision: Revise Major
29 Jan 20211st Revision Received
29 Jan 2021Review(s) Completed, Editorial Evaluation Pending
04 Feb 2021Reviewer(s) Assigned
15 Feb 2021Editorial Decision: Accept
19 Feb 2021Published in Pediatric Allergy and Immunology. 10.1111/pai.13479