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

  • Marion Mickler
  • Konstantin Drexler
  • Stephan SchremlEmail author
case report


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].

Case representation

A 24-year-old man reported, after having consumed wheat-containing products (noodles, white bread) before physical exercise, to have reacted with an allergic reaction. He described symptoms like urticaria, angioedema, circulatory disturbance and a loss of consciousness. There was no history of other trigger factors, atopic disease or pollen...


WDEIA Lipid transfer protein syndrome LTP Tri a 14 


Conflict of interest

M. Mickler, K. Drexler and S. Schreml declare that they have no competing interests.


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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Marion Mickler
    • 1
  • Konstantin Drexler
    • 1
  • Stephan Schreml
    • 1
    Email author
  1. 1.Department of DermatologyUniversity Medical Center RegensburgRegensburgGermany

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