Subject(s)
Botulinum Toxins, Type A , Dermatitis, Allergic Contact , Humans , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/diagnosis , Female , Botulinum Toxins, Type A/adverse effects , Serum Albumin, Human/adverse effects , Patch Tests , Neuromuscular Agents/adverse effects , Middle AgedSubject(s)
Coloring Agents/adverse effects , Rosaniline Dyes/adverse effects , Urticaria/chemically induced , Acetaminophen/adverse effects , Administration, Oral , Analgesics, Non-Narcotic/adverse effects , Anti-Bacterial Agents/adverse effects , Breast Neoplasms/surgery , Coloring Agents/administration & dosage , Excipients , Female , Humans , Hypersensitivity, Immediate/chemically induced , Intradermal Tests , Methacycline/adverse effects , Middle Aged , Rosaniline Dyes/administration & dosage , Sentinel Lymph Node Biopsy , Skin TestsSubject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Antineoplastic Agents, Immunological/adverse effects , Drug Eruptions/etiology , Melanoma/drug therapy , Nivolumab/adverse effects , Programmed Cell Death 1 Receptor/antagonists & inhibitors , Skin Neoplasms/drug therapy , Vitiligo/chemically induced , Adult , Aged , Aged, 80 and over , Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Agents, Immunological/therapeutic use , Female , Humans , Male , Melanoma/mortality , Middle Aged , Nivolumab/therapeutic use , Retrospective Studies , Skin Neoplasms/mortality , Survival RateABSTRACT
A 17-year-old woman, high-performance triathlete, presented transient abdominal pain, face angioedema and sometimes syncope during exercise. Exercise-induced anaphylaxis was suspected at first. Allergic explorations with skin prick tests were negative but wheat flour specific IgE and recombinant rTri a14 (LTP) were weakly positive. However, wheat eviction did not improve the symptoms and stress test after wheat oral challenge did not show any signs of anaphylaxis. An abdominal ultrasound revealed peak expiratory velocities with a stenosis evaluated at 70 to 80 percent with turbulences in the celiac artery, confirmed by computed tomography angiogram. The diagnosis of exercise-induced median arcuate ligament syndrome (MALS) was retained and we discuss here the challenging diagnosis mimicking exercise-induced anaphylaxis.
