As with many food hypersensitivity reactions, the diagnosis of wheat allergy is challenging.
The diagnostic path often involves the exclusion of other conditions. Additionally there must be carefully monitored exclusion and reintroduction of offending foods.
IgE mediated wheat allergyClinicians are faced with reported wheat/gluten related intolerances on a regular basis, with little evidence about the usefulness of current skin prick tests (SPT) and specific IgE tests in the diagnostic work-up of IgE mediated wheat allergy. Skin prick tests and/or specific IgE tests alongside a good clinical history or food challenge are used as the mainstay for the diagnosis of wheat allergy. However, a number of studies have recently been published on the diagnostic usefulness of component resolved diagnostics in the diagnosis of wheat allergy, indicating that these may be useful tests  in distinguishing those with true wheat allergy.
Non-IgE mediated wheat allergyThe diagnosis of non-IgE mediated wheat allergy is more complex with a lack of any validated test. The only way of diagnosing non-IgE mediated wheat allergy is to avoid the offending food (usually for a period of between 2-6 weeks) with a monitored reintroduction of the food. Depending on the underlying pathology and severity of past reactions, this reintroduction could be carried at home or in a clinical setting.
- Mäkelä MJ, Eriksson C, Kotaniemi-Syrjänen A, Palosuo K, Marsh J, Borres M, Kuitunen M, Pelkonen AS. Wheat allergy in children - new tools for diagnostics. Clin Exp Allergy. 2014 Nov;44(11):1420-30.