食物依存性運動誘発アナフィラキシー

Abstract

Food-dependent exercise-induced anaphylaxis (FEIAn) is a rare disease. The disease is classified into physical allergy and/or a subtype of food allergy. However, the pathophysiology and epidemiology are not well known. In this article we presented our studies of the epidemiology of FEIAn, in school students (elementary. junior-high, and high school) in Yokohama City and/or Kanagawa Prefecture, Japan. Also, we reviewed FEIAn cases in the literatures in Japan as well as in foreign countries. Six hundred and seven school nurses responded the questionnaire, 30 (Male:Female, 24:6) cases of FEIAn and 44 (M:F, 22:22) with exercise-induced anaphylaxis (EIAn) among 353977 students were reported. The frequency of FEIAn and EIAn was 0.0085% and 0.012%, respectively. Only one third of nurses had knowledge of FEIAn. We performed provocation tests in 11 of the 30 students with FEIAn and confirmed the diagnosis. We demonstrated transient increases in plasma histamine but not serum tryptase levels during the tests. The causative foods were mainly wheat and crustaceans in 170 Japanese cases and beans and wheat in foreign countries. As for exercise, ball games and running were more frequent sports in both groups. The age of first episode of FEIAn was 10 to 20 years old in most cases. Provocation test often fails to induce symptoms. In addition, we do not have the standard method. Now we are establishing the protocol. FEIAn and EIAn are relatively rare among school students in Japan. There is no evidence to prevent the onset of FEIAn with medicines. Therefore, to avoid serious outcomes and unnecessary restriction, we believe it is important to be familiar with the diseases for not only physicians, but also school nurses and teachers of physical education.