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Grain allergy: Clinical features, diagnosis, and management

Kirsi M Jarvinen-Seppo, MD, PhD
Section Editor
Scott H Sicherer, MD, FAAAAI
Deputy Editor
Elizabeth TePas, MD, MS


Grain allergies are common food allergies that are typically but not only seen in individuals with other food allergies. The immunologic responses to grain proteins can be immunoglobulin E (IgE) mediated and/or non-IgE mediated. Food allergy to wheat is best known and manifests with a variety of symptoms and a wide range of clinical syndromes, such as atopic dermatitis exacerbations, exercise-induced anaphylaxis, eosinophilic esophagitis (EoE), baker's asthma, and celiac disease. This topic review highlights wheat and also covers other cereal grains including rye, barley, oat, rice, corn, and millet, as well as non-cereal grains including quinoa, amaranth, buckwheat, and sorghum.

The epidemiology, clinical features, diagnosis, and management of grain allergy are presented in this topic review. An overview of grains and their classification, as well as the major grain allergens, are discussed in detail separately. (See "Grain allergy: Allergens and grain classification".)

General discussions of food allergy are presented separately in other topic reviews.

Wheat allergy related to occupational exposure is presented separately, as is food-dependent (including wheat) exercise-induced anaphylaxis and celiac disease (gluten-sensitive enteropathy):

(See "Occupational asthma: Definitions, epidemiology, causes, and risk factors" and "Occupational asthma: Pathogenesis" and "Occupational asthma: Clinical features and diagnosis" and "Occupational asthma: Management, prognosis, and prevention".)

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Literature review current through: Nov 2017. | This topic last updated: Jan 13, 2017.
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