Acute Myocardial Infarction following Food-dependent Exercise-induced Anaphylaxis

Yaegashi, Takanori; Nakamura, Yukio; Sakagami, Satoru; Saeki, Takahiro; Omi, Wataru; Ikeda, Keiko

doi:10.2169/internalmedicine.50.4467

Cited by 12 publications

(7 citation statements)

References 23 publications

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“…There are many case reports regarding AMI as an in-hospital complication of patients treated for conditions, such as endocarditis [24,25], acute pancreatitis [26], rheumatoid arthritis [27], venous thromboembolism [28], diabetes mellitus [29], antiphospholipid syndrome [30], ovarian hyperstimulation syndrome [31], anorexia nervosa [32], anaphylaxis [33], and blunt chest trauma [34]. Among the 121 patients with somatic conditions in this study (n = 121), the most frequent diagnosis was gastrointestinal (25%), followed by urological (20%) and neurological (18%) diseases.…”

Section: Discussionmentioning

confidence: 99%

Inpatient versus outpatient onsets of acute myocardial infarction

Erné

Bertel

Urban

et al. 2015

European Journal of Internal Medicine

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Section: Discussionmentioning

confidence: 99%

Inpatient versus outpatient onsets of acute myocardial infarction

Erné

Bertel

Urban

et al. 2015

European Journal of Internal Medicine

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“…It has been claimed that at least 33-50% of patients with EIA suffer from FDEIA. Acute myocardial infarction may be a rare, but severe complication of FDEIA [13]. In FDEIA, allergic reactions are elicited only when a triggering cofactor, such as physical activity, is added after ingestion of the causative food.…”

Section: Food-dependent Exercise-induced Anaphylaxismentioning

confidence: 99%

“…Typical type I allergic symptoms such as pruritus, urticaria, and dyspnoea usually appear on the skin, mucous membranes, and the respiratory and gastrointestinal tracts. Acute myocardial infarction may be a rare, but severe complication of FDEIA [13]. FDEIA is potentially life-threatening, and cases of death have been ascribed to FDEIA [14,15].…”

Section: Food-dependent Exercise-induced Anaphylaxismentioning

confidence: 99%

Wheat‐dependent exercise‐induced anaphylaxis

Scherf

Brockow

Biedermann

et al. 2015

Clin Experimental Allergy

157

131

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Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a rare, but potentially severe food allergy exclusively occurring when wheat ingestion is accompanied by augmenting cofactors. It is clinically characterized by anaphylactic reactions ranging from urticaria and angioedema to dyspnoea, hypotension, collapse, and shock. WDEIA usually develops after ingestion of wheat products followed by physical exercise. Other cofactors are acetylsalicylic acid and other non-steroidal anti-inflammatory drugs, alcohol, and infections. The precise mechanisms of WDEIA remain unclear; exercise and other cofactors might increase gastrointestinal allergen permeability and osmolality, redistribute blood flow, or lower the threshold for IgE-mediated mast cell degranulation. Among wheat proteins, ω5-gliadin and high-molecular-weight glutenin subunits have been reported to be the major allergens. In some patients, WDEIA has been discussed to be caused by epicutaneous sensitization with hydrolysed wheat gluten included in cosmetics. Diagnosis is made based on the patient's history in combination with allergy skin testing, determination of wheat-specific IgE serum antibodies, basophil activation test, histamine release test, and/or exercise challenge test. Acute treatment includes application of adrenaline or antihistamines. The most reliable prophylaxis of WDEIA is a gluten-free diet. In less severe cases, a strict limitation of wheat ingestion before exercise and avoidance of other cofactors may be sufficient.

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“…However, to the best of our knowledge, it has never been reported that the hypercoagulable state seen in CU is associated with an increased risk of thrombosis. On the contrary, there are a number of reports of cardiovascular events (particularly myocardial infarction) occurring during episodes of acute urticaria [54][55][56][57]. Various pathomechanisms have been hypothesized to link urticaria and the cardiac events, including coagulation involvement, coronary artery spasm and/or atheromatous plaque erosion or rupture induced by inflammatory mediators.…”

Section: Clinical and Therapeutical Implicationsmentioning

confidence: 99%

Chronic Spontaneous Urticaria: the Emerging Role of Coagulation

et al. 2013

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Chronic urticaria (CU) is a cutaneous disease characterized by the recurrent eruption of short-lived wheals for at least six weeks. The wheals, which are surface swelling of the dermis accompanied by itching, may be elicited by different stimuli, or occur spontaneously. The pathogenesis of spontaneous CU has long remained a mystery, with food allergy, intolerance to food additives and chronic infections having been indicated as the main causes of the disease. The demonstration of histamine releasing autoantibodies in the serum of CU patients led to consider it of autoimmune origin in about 45 % of cases, this condition being "idiopathic" in the remaining 55 %. We recently evaluated the possible involvement of blood coagulation in its pathophysiology by measuring in CU patients the plasma levels of prothrombin fragment F1+2, a polypeptide released into the circulation during the activation of prothrombin to thrombin, and D-dimer, a marker of fibrin lysis. Interestingly, both F1+2 and D-dimer plasma levels were extremely high during the acute phase of disease, but were completely normal after remission, paralleling urticaria severity. It is noteworthy that thrombin causes an increase in vascular permeability, thus amplifying the CU inflammatory network. Moreover, immunohistochemical studies showed expression of tissue factor, the main initiator of coagulation, in CU skin lesions, and co-localization experiments demonstrated that tissue factor is expressed by eosinophils in the inflammatory infiltrate. All these findings support that coagulation activation contributes in the pathophysiology of spontaneous CU, and provide the rationale for using also anticoagulant and antifibrinolytic agents to treat it.

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Acute Myocardial Infarction following Food-dependent Exercise-induced Anaphylaxis

Cited by 12 publications

References 23 publications

Inpatient versus outpatient onsets of acute myocardial infarction

Inpatient versus outpatient onsets of acute myocardial infarction

Wheat‐dependent exercise‐induced anaphylaxis

Chronic Spontaneous Urticaria: the Emerging Role of Coagulation

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