A Case Report of Food-Dependent Exercise-Induced Anaphylaxis in a Patient who was Sensitive to Pork / 소아알레르기및호흡기학회지

Food-dependent exercise-induced anaphylaxis (FDEIA) is a specific variant of exercise-induced anaphylaxis that requires both vigorous physical activity and the ingestion of specific foods. In particular, it is rare occurrence for FDEIA to be associated with meat in Korea. A 15-year-old female had generalized urticaria, dyspnea, severe cough, headache, dizziness, and vomiting after singing and dancing for 1 hour and after ingesting grilled pork. Skin prick tests showed a strong positive reaction to pork, whereas the results of an oral food challenge and exercise provocation tests were negative. However, the exercise provocation test after pork ingestion showed a positive reaction manifested by generalized urticaria, cough, mild dyspnea, and a 23% decreased peak expiratory flow rate. Three allergens to pork (67 kDa, 90 kDa, and 15 kDa) reacted with the patient's serum on immunoglobulin E immunoblotting. We report a case of pork-dependent exercise-induced anaphylaxis in a patient who was sensitive to pork.

Wheat-dependent, Exercise-induced Anaphylaxis: A Successful Case of Prevention with Ketotifen

Food-dependent, exercise-induced anaphylaxis (FDEIA) is the triggering of anaphylaxis after ingestion of certain foods when followed by physical exercise. Symptoms vary from the typical generalized urticaria to severe allergic reactions. We report the case of a 20-year-old woman who had a 7-year history of recurrent wheals and dyspnea after ingesting several kinds of food (wheat, pork, and beef) along with physical exercise. Based on a provocation test, she was diagnosed with wheat-dependent, exercise-induced anaphylaxis. She was instructed to take 2 mg of ketotifen 2 hours before ingestion of wheat to prevent the symptoms, and subsequently the provocation test did not elicit wheals. We therefore prescribed ketotifen (1 mg twice a day). She has not had recurrent wheals or dyspnea for 6 months. We herein report an interesting case of wheat-dependent, exercise-induced anaphylaxis with successful prevention by ketotifen.

Food ( wheat flour ) dependent exerclse - induced anaphylaxis in asthmatics : related with the amont of wheat flour and exercise / 천식및알레르기

A 25-year-old male with asthma suffered from generalized urticaria, angioedema and syncope associated with exercise after ingestion of food made with wheat flour. Skin prick test with bread showed strong positive reaction(++++), but with wheat flour, a weak positive(+). Challenge test with wheat flour, and food made with wheat flour, without or with exercise, were done several times. Exercise such as 25 min of running on treadmill following 30 min after 50 grams of bread or 50 grams of hot pepper-stuffed rice cake only showed positive reaction such as generalized urticaria, angioedema and hypotension, but not with 15 grams of bread or 15 grams of hot pepper-stuffed rice cake. Ingestion of bread in such high amounts as 15 grams alone did not trigger reaction, not even with is min of exercise. This is the first clear case of food dependent exercise induced anaphylaxis (FDEIA) in which the allergic reaction depended on both the amount of food ingested and the amount of exercise was clarified.