Jiang et al reported a number of recommendations for managing a patient with wheat-dependent, exercise-induced anaphylaxis (WDEIA). The authors are from Peking Union Medical College Hospital and the Chinese Academy of Medical Sciences in Beijing.
Patient selection: wheat-dependent exercise-induced anaphylaxis
Things to avoid:
(1) avoid consuming wheat products less than 6 hours before exercise
(2) avoid factors (NSAIDS, aspirin, alcohol) that can augment the effect of wheat if a wheat product is consumed
(3) avoid consuming wheat products in the presence of an infection
(4) avoid consuming wheat products or products containing gluten if prescribed daily aspirin
Precautions when exercising:
(1) have an epinephrine injector available
(2) have a mobile phone available
(3) have a companion present
(4) have medications available for early symptoms (see next)
Response to symptoms:
(1) take a first-generation H1 antihistamine if early skin symptoms (hives, pruritis, flushing) occur
(2) inhale a short-acting beta-2 adrenoceptor agonist (salbutamol, other) if asthmatic symptoms occur
