Case Of Food-dependent Exercise-induced Anaphylaxis Research Articles

A Case of Food-dependent Exercise-induced Anaphylaxis Diagnosed by Provocation Test with Spear Squid After the Pretreatment with Asprin

16 歳，男性。夕食時にヤリイカを含む寿司を摂取した約 1 時間後，歩行帰宅途中に眼瞼浮腫，全身に蕁麻疹が出現した。前医を受診し，収縮期血圧低下を認めアナフィラキシーショックと診断され加療された。食物アレルギー精査目的に当科に紹介受診となり，食物依存性運動誘発アナフィラキシー（fooddependent exercise-induced anaphylaxis：FDEIA）を疑い精査を行った。イカを含む数種の魚介類の特異的 IgE 抗体が陽性であった。Prick-prick test ではヤリイカのみ陽性となった。ヤリイカを原因食物として疑い，入院下で運動負荷誘発試験を施行した。運動とヤリイカの摂取のみでは症状誘発はされなかったが，アスピリン 1.5 g を内服しヤリイカ 50 g の摂取と 30 分間の運動との組み合わせで眼瞼浮腫を生じた。以上よりヤリイカによる FDEIA と診断した。本症は診断のために詳細な問診と特異的 IgE 抗体の測定，プリックテスト，食物負荷試験が重要であるが必ずしも再現性は高くない。食物負荷試験と運動の組み合わせでは偽陰性となることがあり，自験例の結果より増強因子であるアスピリンを投与することも重要であることが示唆された。

A pediatric case of food-dependent exercise-induced anaphylaxis due to bathing after peach ingestion

A pediatric case of food-dependent exercise-induced anaphylaxis due to bathing after peach ingestion

Mixed plant extract-dependent exercise-induced anaphylaxis

Food-dependent exercise-induced anaphylaxis (FDEIA) is a potentially life-threatening clinical reaction in which anaphylaxis develops when physical activity occurs within a few hours after ingesting a specific food. An 18-year-old girl experienced generalized urticaria, periorbital swelling, and dyspnea repeatedly by exercise after intake of a red ginseng health supplement. A confirmed diagnosis was established in this case by using an exercise challenge test after ingesting mixed-plant extract containing red ginseng health supplement. To the best of our knowledge, this is the first case of FDEIA caused by components in a red ginseng health supplement. (Allergy Asthma Respir Dis 2015;3:219-223)

Two cases of food-dependent exercise-induced anaphylaxis with different culprit foods

Food-dependent exercise-induced anaphylaxis (FDEIA) is one of the severe allergic reactions in which symptoms develop only if exercise takes place within a few hours of eating a specific food. It is important to consider FDEIA in cases of unexplained anaphylaxis as reactions can occur several hours after ingesting the culprit food(s). We herein report the first two cases of FDEIA in the Middle East. The first one is induced by wheat, while the other by peanut. The pathophysiology, predisposing factors, diagnosis, and treatment of FDEIA are also summarized here.

Specific Oral Tolerance Induction Using IFN-Gamma in 2 Cases of Food-Dependent Exercise-Induced Anaphylaxis

Anaphylaxis induced by exercise after the intake of certain foods is referred to as food-dependent exercise-induced anaphylaxis (FDEIA). Only the preventive medication such as oral sodium cromoglycate and oral combined cetirizine-montelukast was tried in FDEIA. Specific oral tolerance induction (SOTI) using IFN-gamma was tried in 2 cases of FDEIA for wheat. Merely, exercise accompanied every treatment just after the intake of allergenic foods during treatment. Patients acquired tolerance for wheat in both cases successfully. After treatment, two patients take wheat in their food living freely. Conclusively, SOTI using IFN-gamma was effective as the causative treatment for allergenic foods in FDEIA.

A Case of Food-dependent Exercise-induced Anaphylaxis due to Wheat: Intake of Aspirin and Wheat without Exercise-induced Anaphylaxis

A Case of Food-dependent Exercise-induced Anaphylaxis due to Wheat: Intake of Aspirin and Wheat without Exercise-induced Anaphylaxis

A Case of Food-Dependent Exercise-Induced Anaphylaxis (FDEIA) Caused by Wheat

A Case of Food-Dependent Exercise-Induced Anaphylaxis (FDEIA) Caused by Wheat

食物依存性運動誘発アナフィラキシー

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.

Frequency of food-dependent, exercise-induced anaphylaxis in Japanese junior-high-school students

Background: Food-dependent, exercise-induced anaphylaxis (FEIAn) is classified among the physical allergies. The pathophysiology of FEIAn remains unknown, as does the frequency of FEIAn in the general population. Objective: We sought to study the epidemiology of FEIAn, especially its frequency in junior-high-school students in Yokohama, Japan. Methods: A questionnaire asking about the occurrence of FEIAn in school students was sent to all 145 public junior-high-school nurses in Yokohama. Results: One hundred thirty-two junior-high-school nurses responded to the questionnaire, and 13 (11 boys and 2 girls) cases of FEIAn among 76,229 junior-high-school students were reported. In addition, 24 (12 boys and 12 girls) subjects with exercise-induced anaphylaxis (EIAn) were detected. From this survey, the frequency of FEIAn was 0.017% in this population, and its frequency was significantly higher in boys than in girls (P < .05). The frequency of EIAn was 0.031%, and there was no difference according to sex. Only one third of junior-high-school nurses had any knowledge of FEIAn. We also performed provocation tests in 5 of the 13 cases with FEIAn after obtaining informed consent from the students and their parents and were able to confirm the diagnosis. Conclusion: This study showed that FEIAn and EIAn are relatively rare diseases among junior-high-school students in Yokohama. To avoid serious outcomes, we believe it is important that not only physicians but also school nurses and teachers of physical education be aware of these diseases. (J Allergy Clin Immunol 2001;108:1035-9.)

Food‐dependent exercise‐induced anaphylaxis: a case related to the amount of food allergen ingested

A 24-year-old Japanese woman had suffered for 2 years from attacks of urticaria, dyspnoea and syncope associated with exercise after the ingestion of wheat. Specific IgE measurements revealed RAST class 2 for wheat and gluten (a major wheat protein), and class 3 for rye. Skin prick tests with wheat, bread, gluten and udon (a Japanese noodle made of wheat) were all positive. Food-dependent exercise-induced anaphylaxis (FDEIA) caused by wheat was suspected. Challenge tests with bread were performed. Exercise following ingestion of 64 g, but not 45 g, of bread induced generalized urticaria. Challenge tests with udon also triggered allergic reaction in a dose-dependent manner: 200 g, but not 100 g or 150 g, of udon elicited wealing and erythema with exercise. Ingestion of bread or udon alone failed to elicit any allergic reaction. This is the first case of FDEIA in which the dependence of the triggering allergic reaction on the amount of allergen ingested was clearly confirmed.