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BACKGROUND : Sensitisation to wheat demonstrated by specific IgE without clinical reactions to ingested wheat is common. Clinical allergy towards wheat may cause anaphylactic or mild reactions. Until now, oral challenge tests have been necessary for diagnosing severe reactions to ingested wheat. We wanted to distinguish between severe and mild reactions by using three different IgE tests against wheat. MATERIAL AND METHODS : 29 children with elevated levels of specific IgE against wheat (f4 test) were referred to our hospital for further diagnostic procedures. We performed specific IgE tests against different wheat components (f4, f79 and f98) and oral provocation tests. RESULTS : 10 children with severe clinical reactions had high levels at all three specific IgE tests and comparable levels between the tests. The 4 children with mild reactions showed varying values of IgE but very similar levels between the three different tests. 15 children had negative provocation tests, varying levels of specific IgE, and less similar levels between the tests. INTERPRETATION : Available specific IgE tests are not useful in order to distinguish between severe, mild or no clinical reactions to ingested wheat. Oral challenge tests are still needed for correct diagnosis of severe wheat allergy.

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