March 17, 2017

Food-dependent, exercise-induced anaphylaxis triggered by co-incidence of culprit food, physical effort and a very high dose of ibuprofen or menstruation: a case report

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Food-dependent exercise-induced anaphylaxis (FDEIA) is defined as anaphylaxis resulting from co-incidence of ingestion of sensitizing food and physical activity, while any of those factors alone does not cause any adverse reactions []. A pathophysiological mechanism of FDEIA still remains not fully elucidated. An IgE-dependent mechanism triggered by ingestion of culprit food and confirmed by positive skin prick tests and/or specific IgE antibodies seems to be unquestionable. The role of physical exercise is not so obvious. It is considered that exercising increases absorption of nutrients from gastrointestinal mucosa into the systemic circulation []. This assumption is supported by the fact that alcohol or nonsteroidal anti-inflammatory drugs (NSAIDs) are able to amplify an exercise-induced effect []. In some individuals NSAIDs are able either to independently substitute exercise [] or act as an ultimate third co-factor for exercise and food allergen in triggering FDEIA []. It has been also demonstrated that in some patients FDEIA symptoms occurr only during menstruation []. We describe a patient in whom FDEIA symptoms occur only if exercising and ingestion of ....

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