چکیده (انگلیسی):

Background: Low-dose reactive wheat-allergic children are at a high risk of a positive oral food challenge
(OFC). The present study aimed to evaluate whether the results of a very low-dose (VL) OFC would
contribute to better wheat allergy management in this population.
Methods: We retrospectively reviewed wheat-allergic subjects who underwent a VL OFC with 2 g of
udon noodles (equivalent to 53 mg of wheat protein) and had a previous allergic reaction to <15 g of
udon noodles (equivalent to 400 mg of wheat protein) within 2 years before the OFC. Subjects who
passed the OFC were defined as VL tolerant; those who failed were considered VL reactive. In VL tolerant
subjects, the dose was increased to 15 g of udon noodles either during an OFC in our hospital or gradually
at home.
Results: Of the 57 included subjects (median age, 2.9 years; range, 1.0e11.8 years), 32 (56%) were VL
tolerant and 25 (44%) were VL reactive. Most reactions during the OFC could be treated with an antihistamine
and/or a nebulized b2 agonist. VL tolerant subjects consumed 2 g of udon noodles or a
seasoning containing wheat. Within a year after the OFC, 18 VL tolerant subjects (56%), but no VL reactive
subjects, were able to consume 15 g of udon noodles (p < 0.001).
Conclusions: A VL OFC can shift the management of some low-dose reactive wheat-allergic children from
complete avoidance to partial wheat intake.