Allergie à la farine de blé chez l’adulte

The clinical manifestations of allergy to wheat flour are similar to those of allergies to other foods. In adults, food-dependent exercise-induced anaphylaxis, chronic urticaria, and gastrointestinal food allergies (that is, irritable bowel syndrome, eosinophilic colitis, ulcerative colitis) are the most frequently described clinical manifestations of allergy to wheat. Wheat isolates, used as binders and emulsifiers in the food industry, are neo-allergens resulting from chemically induced desamidation of wheat gluten (heating at high temperature in an acidic medium). Wheat isolate allergens can induce severe systemic reactions (e.g., urticaria) and anaphylactic shock. Diagnosis consists of three steps: a suspicion based on the patient's history, identification of the allergen by skin testing and by laboratory tests, and confirmation by oral challenge or by an avoidance regime.