Karen did a Cyrex Array 3 on a 12-year-old patient. She had IgG antibodies to wheat and wheat germ agglutinin. The family eats a fairly conventional diet and the mother does not want to make her diet unnecessarily restrictive. Should she avoid wheat in addition to rye and barley or only wheat?

Dr. Amy Nett: Okay. I don’t know that it would be unnecessarily restrictive to remove wheat based on those markers.

I don’t know that I can answer that question without a Cyrex Array 4. I would consider doing the Cyrex Array 4 because Cyrex Array 3 is—you’re saying wheat and wheat germ agglutinin. So wheat germ agglutinin is a lectin, so I don’t know how specific the wheat agglutinin on Cyrex Array 3 is to wheat or if it can potentially be associated with the agglutinins, with some of the proteins that can be found in rye and barley. So, you could call Cyrex and see if they have more insight into the likelihood of the agglutinin potentially being a problem with rye and barley because I’m not certain about that. You could alternatively consider a Cyrex Array 4, but that sort of lumps the gluten-containing grains together.