AbstractIntroductionWheat sensitization is common but IgE antibodies (IgE‐abs) to wheat are not predictive of clinical symptoms in children with suspected wheat allergy. Wheat allergen components other than ω‐5 gliadin have not been well studied. Our aim was to characterize the clinical profile and investigate the value of adding measurements of IgE‐abs to wheat components in a group of children with a doctor's diagnosed wheat allergy.MethodSixty‐three children with a doctor's diagnosis of wheat allergy confirmed sensitization to wheat and, on a wheat elimination diet, went through oral wheat challenges or had a convincing recent history of wheat allergy. IgE‐ab to ω‐5 gliadin, low molecular weight glutenin (LMW‐glutenin), high molecular weight glutenin (HMW‐glutenin) and a native gliadin preparation containing α‐, β‐, γ‐, and ω‐gliadin (gliadin) were analyzed.ResultsTwenty‐six children were positive in challenge, while six children were regarded as wheat allergic due to recent anaphylactic reactions. The IgE‐ab levels to all four wheat components were significantly higher in the group with wheat allergy compared to the group with no wheat allergy (p < 0.0001). Also, the severity of symptoms at challenge correlated with the IgE‐ab levels to all four components (p < 0.05). IgE‐ab levels to ω‐5 gliadin correlated best with challenge outcome, and by additional analysis of gliadin, HMW‐ and LMW‐glutenin IgE‐abs all challenge positive children could be identified.ConclusionMany children diagnosed as wheat allergic have outgrown their allergy and are unnecessarily on a wheat‐free diet. The levels of IgE‐ab to wheat gluten‐derived components correlated well with wheat challenge outcome and severity.