Wheat-dependent exercise-induced anaphylaxis with Tri-a-14-sensitization as part of a lipid transfer protein syndrome

Background Wheat-dependent exercise-induced anaphylaxis (WDEIA) is the most common and best known form of food-dependent exercise-induced anaphylaxis (FDEIA) [1]. It is a summation anaphylaxis, in which the patient only shows an allergic reaction when eating wheat-containing food in combination with trigger factors, e. g. physical exercise, medical drugs (e. g. NSAIDs) or alcohol [1, 2]. The major allergen known for WDEIA is omega-5-gliadine (Tri a 19, a storage protein) [3]. Tri a 14 is a lipid transfer protein (LTP) in wheat. LTPs, which can be found in many different plants, are resistant to heat and digestion [4, 5].