000167 - Omega 5 Gliadin positive presentation clinical profile

Omega 5 Gladin is a maker for wheat dependent exercise induced anaphylaxis(WDEIA) a rare but life threateningallergic condition triggered by the ingestion of what and physical activity. In this we report ten positive cases in the community clinic in India in the last twelve months along with their varied  clinical presentation. This study underscores the importance of recognizing the importance of Omega 5 gliadin as a key diagnostic marker for increased awarenessof this condition among healthcare professionals in regions nwhere it may be underdiagnosed.

Patients attending our allergy clinic with idiopathic , intermittent urticaria and infants with severe Atopic dermatitis were subjected to Alexi Component resolved diagnosis which measured 300 allergens including 50 aeroallergens.

Ten patient, 3 male and 7 females were identified. five were adults and five were less than 16 years. All had raised Omega 5 Gladin levels. There was no apparent correlation between Tri a 19 level and severity of symptoms . Two infants had moderate to severe AD without urticaria and increase in Tri 19 was accompanied by an increase in other wheat component along with a marked increase in Total IgE. Five had other comorbid allergies. three had no other allergies positive, 5 had dust mites positive and 3 had tropomyosin cross-reactive protein positive

After testing positive for omega 5 gladin, 7 of these 10 positive pateints could correlate symptoms with wheat and exercise but only one of the pateint had associated wheat with their symptoms before testing. One could not correlate with wheat and two had only Atopic dermatitis without ever having consumed wheat. 

None of the Omega 5 gladin positive cases were positive on skin prick test for whole wheat when tested with a skin prick test. 

With the availability of advanced CRD testing , we diagnosed 7 cases of wheat dependant exercise induced urticaria, which woud have been missed by routine testing methods. Hence, we suggest that omega 5 gladin testing for cases of recurrent intermittent urticaia. It may be misleading in cases of Atopic dermatitis with increased total IgE levels.