Allergic reaction to flour? It doesn’t have to be gluten at all

Proven content

To find out if and what kind of allergy we have, it is best to do two different tests. This allows us to detect what we are really hypersensitive to. Because it may turn out that it is not gluten at all. Or that our peanut allergy is not as dangerous as we think it is.

1. It is a good idea to perform an allergy test if symptoms occur under certain circumstances – repeatedly or always in the same situation
2. There are two types of allergy tests available – blood tests and skin tests
3. Read the first part of the interview with Dr. Emilia Majsiak
4. More information can be found on the Onet homepage.

Agnieszka Mazur-Puchała, Medonet: Everything indicates that we are allergic and it would be good to do the tests. What do they look like? Is it cutting the skin 40 times and putting the allergens under the skin? Is it done differently now?

Dr Emilia Majsiak, specialist in molecular diagnostics of allergies: These 40 injections sound very brutal. And it is just a small puncture with a lancet with a blade of approx. 1 mm of the epidermis to a depth of approx. 0,4 mm – it is really not much. This test is called a skin test, and in adults it is usually done on the inside of the forearm. On the back, it is most often done in young children. The test itself consists in putting a drop of the allergen extract and two controls (negative and positive) on the skin of the examined patient, then puncturing the epidermis to introduce allergens and reading the result after 15-20 minutes. The skin test allows you to test the reaction to an allergen and find out if the patient reacts to the allergen in the form of a blister on the skin.

The second option is to test the blood for the presence of allergen-specific E antibodies (sIgE). Until recently, these antibodies could only be tested against whole allergens, but now we can test the individual proteins of these allergens. For example, we are able to investigate whether a patient allergic to birch has E antibodies to the main birch molecule (Bet v 1) or to the so-called smaller birch allergen (Bet v 2). Information about which of them sensitizes the patient is very important, because it is associated with other therapeutic paths of such a patient. At the moment, we know that patients allergic to Bet v 1 are likely to benefit from immunotherapy. This protein belongs to the group of proteins – PR10, which we know are present in apple, carrot, celery and strawberry.

Therefore, we can check if his antibodies recognize these foods and advise the patient to pay attention to how his body responds to these foods. Simply put, we can give him instructions on what he should avoid when pollinating so as not to increase the amount of the allergen that causes him to react. In the case of a positive Bet v 2 (i.e. a protein belonging to the profilin group), there is a high risk that the patient will not receive the expected benefit from immunotherapy. Perhaps the only effective form of treatment in patients with Bet v 2 allergy will be conservative treatment aimed at reducing symptoms.

Molecular diagnostics can be especially helpful in the case of allergies that we fear, such as allergies to nuts or grains. If you have had symptoms of hypersensitivity in the past after eating these foods, and the blood test confirms the presence of E antibodies to a group of molecules called storage proteins, then this is the patient who is at risk of anaphylactic shock. This is very important information for mothers of young children, kindergartens and schools. With such an allergy, even trace amounts of peanuts can trigger a reaction and the person must always have adrenaline with him. The situation is different with the recommendations and conduct in a patient who is found to have antibodies to the peanut molecule 8 (Ara h 8, PR10 protein group). In this case, such an allergy is not associated with a threat to the patient’s life, because such an allergy is the result of a cross-reaction with Bet v 1 birch and such a person should be diagnosed for inhalation allergy to birch pollen.

Are any of these tests better? Should you do both?

Ideally, skin tests and blood tests should be done, as they give the most complete picture together. Both have their advantages and disadvantages, so one can say that one complements the other. Skin tests involve introducing an allergen into the patient’s body, therefore several conditions must be met – e.g. the patient must stop taking anti-allergic drugs a few days before the test. We also do not perform skin tests with allergens that are currently dusty, so such patients must wait for the diagnosis until the end of the pollen season. We cannot perform them if the patient has skin changes where we want to perform the tests. The contraindication to perform the tests is also the high risk of anaphylaxis in the patient.

Blood tests, on the other hand, are confirmation tests, not exclusion tests. This means that if we find antibodies and the patient has symptoms after contact with this allergen, the test allows us to confirm the causative agent of the symptoms and the mechanism of the allergic reaction. But if the result is negative, we cannot rule out allergies.

Dlaczego?

Imagine a situation where you are allergic to apples and you always have serious ailments after apples. You stop eating them because they are bad for you. It takes a year or two, so the body stops producing antibodies. There is no allergen, no need for the immune system to defend itself. Therefore, performing the test just then – we will get a negative result. But your body hasn’t forgotten that it can’t tolerate apples. If you eat this fruit again, antibodies are produced immediately and the reaction may reappear. Immune memory cells remember this allergen. Therefore, only on the basis of the lack of antibodies, we cannot rule out an allergy.

And you just made me realize that I am allergic to beetroot. I haven’t eaten them for several years …

In any form?

Nothing. Beetroots, boiled, baked – I feel bad after all.

Beet allergy is uncommon. But if you have identified a product you are feeling unwell, you have eliminated it from your diet, and there are no negative effects of such restriction, you can say that the situation is under control. And it’s really great that you managed to find out this hypersensitivity based on your observations, because sometimes there are so many allergenic foods that it is difficult to see which foods are the cause of our ailments.

And it’s always easier to give up beet than gluten …

Yes, definitely easier. Although now gluten and, in a way, wheat are blamed quite often for intestinal problems. And sometimes they’re not at all to blame. Let’s take a closer look at a patient who developed severe symptoms of pancake allergy. The patient had to visit the emergency room. Soon after, he found himself at the Emergency Room again. This time after chicken with whitewashed sauce. The first thought is, of course, an allergy to wheat, eggs or milk, because both dishes contained these ingredients. But the blood and skin tests came back negative for flour, egg, and milk. He underwent molecular diagnostics using a test containing almost 300 allergens, including extracts and allergen molecules. Also in this study, “suspected allergens” came out negative. It turned out that the patient was not allergic to any of these suspicious products. It was also not a gluten sensitivity as the patient was challenged orally with wheat flour. The result for the new flour purchased was negative, while the provocation with the flour he used to prepare the pancakes and white chicken sauce was positive. In view of the fact that E antibodies to mites only were detected in the molecular test, it was decided to test this particular flour. It turned out that there were so many mites in it that they caused severe allergic reactions in the patient. Had it not been for the blood test, perhaps the blame would have been blamed on the wheat, and the man would likely have been instructed to remove flour from his diet. Molecular diagnostics is a Sherlock Holmes laboratory who looks for a specific allergen to be able to indicate: “That made you sensitized!”

Do such situations happen more often? Is this a special case?

They happen, but when we are not able to indicate to the patient this specific allergen, the diagnosis is idiopathic anaphylaxis, i.e. of unknown origin. This was the case of a lady who ate a salad in a restaurant, after which she was shocked. Corn, lettuce, tomato, cucumber – ingredients she had eaten in the past and never had any reaction to them. She underwent molecular diagnostics and it turned out that she was allergic to peach and pomegranate. This lady has not eaten a peach for many years because her lips swelled several times in her childhood. The lady with this information went to the restaurant and it turned out that pomegranate juice was actually added to the salad dressing. In the molecular test, the patient obtained a positive result for the molecule Pun g 7 pomegranate, and in the peach there is a very similar molecule of Pru p 7 from the same family of proteins as Pun g 7. risk of unknowingly eating a pomegranate again or drinking pomegranate juice in the future. And yes, she knows what to avoid in her diet.

I also remember the case of a little boy. After eating peanuts, he ended up in the hospital twice. He was immediately subjected to molecular diagnostics using the third-generation test, but the tests showed that he was not hypersensitive to peanuts. And now consternation. I guess this test is bad? Since he ended up in the hospital twice after coming into contact with nuts? But the study found the boy was allergic to mold. After questioning the child’s mother, it turned out that the peanuts were in fact “old”, opened for a long time and lay somewhere downstairs in the cupboard for a long time. And he ate them from the same package twice. The boy was provoked with peanuts in the ward. Such a provocation is a difficult decision for both the doctor and the parent – because it is a test in which there is a direct risk to the child’s life. The boy got peanuts from a new pack and there was no reaction. Mold was to blame in this case.

Also read:

1. Anaphylactic Shock – Everything You Need to Know [EXPLAINED]
2. A runny nose is increasingly one of the first symptoms of COVID-19
3. A runny nose is not only a symptom of an infection. What disease can it be confused with?
4. Where do the dark circles under the eyes come from?

The content of the medTvoiLokony website is intended to improve, not replace, the contact between the Website User and their doctor. The website is intended for informational and educational purposes only. Before following the specialist knowledge, in particular medical advice, contained on our Website, you must consult a doctor. The Administrator does not bear any consequences resulting from the use of information contained on the Website. Do you need a medical consultation or an e-prescription? Go to halodoctor.pl, where you will get online help – quickly, safely and without leaving your home.