TITLE:
Chronic Urticaria Due to Allergy to Wheat Alpha-Amylase Inhibitor Proteins
AUTHORS:
Nagore Arruti Oyarzabal, Olga Villarreal Balza de Vallejo, Nagore Bernedo Belar, Maria Teresa Audicana Berasategui, Natividad Longo Areso, Borja Bartolomé
KEYWORDS:
Alpha-Amylase Inhibitor, Wheat, Chronic Urticaria, Allergy
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.5 No.4,
April
21,
2016
ABSTRACT: Chronic spontaneous urticaria (CSU) is defined as the spontaneous appearance of wheals, angioedema, or both, for at least 6 weeks, due to known or unknown causes [1]. In some patients who present a CSU with daily or almost daily symptoms a type I allergy could be the underlying cause. We present one adult patient with chronic urticaria who was finally diagnosed as a non-occupational case of IgE-mediated wheat allergy manifested following exposure by 3 different routes: inhalation (rhinitis and bronchial asthma), dermal absorption (contact urticaria) and ingestion (systemic chronic urticaria). We were able to detect the culprit proteins by immunoblotting. Serum IgE binds mainly to alpha-amylase/trypsin inhibitors and, to a lesser extent, to other proteins associated with food allergy to grains (e.g. beta-glucanase, serpin, peroxidase). In our opinion, skin prick tests with a food standard battery could help in the etiological diagnosis of chronic urticaria. The identification of responsible allergens could be difficult because only a few complex in vitro techniques allow detecting the allergy to several proteins.