Kennard L, et al. - Herein, the largest cohort of omega 5-gliadin allergic patients to date was retrospectively analyzed in order to gain an in-depth insight into the clinical features of patients with this disease entity. Since the diagnosis of omega-5 gliadin allergy is frequently delayed, testing for omega-5 gliadin specific IgE was recommended for all adult patients presenting with anaphylaxis of unclear cause. For significantly decreasing the risk of future allergic reactions, a gluten-free diet or avoidance of wheat based meals in combination with exercise (if the cofactor is exercise) were proved to be helpful. Since a third of patients continued to have allergic reactions despite dietary advice, it was considered necessary to always prescribe antihistamines and an epinephrine auto-injector.