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My child is allergic to wheat. Does he need to avoid other cereal grains?

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Updated February 01, 2009

Question: My child is allergic to wheat. Does he need to avoid other cereal grains?
Answer: Maybe. Wheat is one of the more common food allergies in children, and it is common for children with wheat allergy to have positive allergy tests to other cereal grains, such as rye, barley, oat and corn. It is also common for people with allergy to grass pollen to have positive allergy tests to these foods as well, because these cereal grains belong to the grass family. However, only about 20% of people with an allergy to one cereal grain have allergies to other cereal grains, and only 20% of people with grass pollen allergy have a true food allergy to any of the cereal grains.

This is an example of cross-sensitivity without clinical cross-reactivity, and demonstrates that positive food allergy tests do not always mean that a person is allergic to the food in question. Sensitization means that a person makes allergic antibodies to the food in question; allergy is the clinical reaction that occurs if the food is eaten. Many atopic people may make allergic antibodies to a number of different foods, but have no apparent reaction with eating these foods.

Once a person has a positive allergy test to a food, however, that person should avoid eating that food until an allergist can decide if the person is allergic or not. Food allergies can be potentially dangerous, and often an oral food challenge needs to be performed under close medical supervision to ultimately prove that a person is not allergic to the food to which they have a positive allergy test.

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Source:

Sicherer SH. Clinical Implications of Cross-Reactive Food Allergens. J Allergy Clin Immunol. 2001; 108:881-90.

DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.

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