Analysis of clinical characteristics of food-dependent exercise-induced anaphylaxis at a single tertiary hospital

ABSTRACT

PURPOSE: Food-dependent exercise-induced anaphylaxis (FDEIA) is a rare subtype of food allergy in which both sensitization to food allergen and exercise as a trigger contribute to its development. However, its pathogenesis is still under investigation. This study compared clinical features, the causative foods, and the degree of sensitization to food between FDEIA and food anaphylaxis to characterize FDEIA more clearly. METHODS: We retrospectively reviewed the medical records of patients who were diagnosed with FDEIA (n=89) or food anaphylaxis (n=115) between 2003 and 2015 at Seoul National University Hospital. RESULTS: Subjects with FDEIA more frequently had urticaria than those with food anaphylaxis (88.8% vs. 76.5%, P=0.024). Whereas patients with FDEIA had less laryngeal edema than those with food anaphylaxis (12.4% vs. 30.4%, P=0.02). Wheat (67.4%) was the most common causative food allergen in FDEIA, whereas seafood (40.9%) was the most common culprit food allergen in food anaphylaxis. Also, subjects with FDEIA showed a lower atopic index score than those with food anaphylaxis (0.55±1.07 vs. 1.21±1.82, P=0.006). CONCLUSION: There were significant differences in clinical manifestation, causative food allergens and the degree of sensitization to food between FDEIA and food anaphylaxis.