The natural history of wheat allergy

Background: Wheat allergy is 1 of the most common food allergies in children, yet few data are available regarding its natural history. Objectives: To define the natural course of wheat allergy and identify factors that help predict outcome in a large referral population of children with wheat allergy. Methods: Patients were included in the study if they had a history of a symptomatic reaction to wheat and a positive wheat IgE test result. Clinical history, laboratory results, and final outcome were recorded for 103 patients who met the inclusion criteria. Resolution of wheat allergy was determined based on food challenge results. Kaplan-Meier survival curves were generated to depict resolution of wheat allergy. Results: Rates of resolution were 29% by 4 years, 56% by 8 years, and 65% by 12 years. Higher wheat IgE levels were associated with poorer outcomes. The peak wheat IgE level recorded was a useful predictor of persistent allergy (P < .001), although many children outgrew wheat allergy with even the highest levels of wheat IgE. Conclusion: The median age of resolution of wheat allergy is approximately 61/2 years in this population. In a significant minority of patients, wheat allergy persists into adolescence. Ann Allergy Asthma Immunol. 2009; 102:410-415.