Exercise-induced anaphylactic reaction to shellfish

Maulitz, Robert M.; Pratt, David S.; Schocket, Alan L.

doi:10.1016/0091-6749(79)90218-5

Cited by 320 publications

(119 citation statements)

References 5 publications

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“…Exercise as a cofactor of anaphylaxis was first reported by Maulitz et al They reported on a patient who developed anaphylactic symptoms two times following jogging after shellfish ingestion, whereas physical exercise as well as shellfish alone was tolerated (4). This constellation emerged to be no singular event and later on was defined as the separate disease entity of 'food-dependent exercise-induced anaphylaxis' (FDEIA).…”

Section: Exercise As Cofactor Of Anaphylaxismentioning

confidence: 98%

About the role and underlying mechanisms of cofactors in anaphylaxis

Wölbing

Fischer

Köberle

et al. 2013

Allergy

178

163

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Anaphylaxis is the systemic and most severe presentation of type I allergy. A number of conditions were identified that modulate the onset of anaphylaxis such as co-or augmentation factors, which significantly lower the allergen dose necessary for triggering anaphylaxis. Next to physical exercise or alcohol consumption, co-administration of nonsteroidal anti-inflammatory drugs (NSAID) or concomitant infectious diseases are well-documented cofactors of anaphylaxis. Registries for anaphylaxis document a role for cofactors in about 30% of anaphylactic reactions. Some disease entities such as 'wheat-dependent exercise-induced anaphylaxis' (WDEIA) are explicitly characterized by elicitation of anaphylaxis only in the presence of at least one such cofactor. Using WDEIA as a model disease, studies demonstrated that exercise increases skin prick test reactivity to and bioavailability of the allergen. Additional data indicate that alcohol consumption and NSAID administration display similar effects. Modulation of the cellular activation threshold is another mechanism underlying cofactor-induced anaphylaxis, most likely also functional when infectious diseases orchestrate elicitation of anaphylaxis. Cofactors are increasingly accepted to play a fundamental role in eliciting anaphylaxis. Consequently, to improve patient management modalities, a better understanding of the underlying mechanisms is warranted. This review aims to update clinicians and clinical scientists on recent developments.

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Section: Exercise As Cofactor Of Anaphylaxismentioning

confidence: 98%

About the role and underlying mechanisms of cofactors in anaphylaxis

Wölbing

Fischer

Köberle

et al. 2013

Allergy

178

163

View full text Add to dashboard Cite

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“…Exercise-induced anaphylaxis has been reported after ingestion of 100 g of canned oysters (Maulitz et al, 1979) and fatal anaphylaxis after consumption of three snails (Wu and Williams, 2004). In a DBPCFC, the cumulative dose of dried snail causing 20 % decrease in forced expiratory volume (FEV1), a measure of systemic allergic reaction, was 120 mg on one child and 400 mg in another (Pajno et al, 2002).…”

Section: Minimum (Observed) Eliciting Dosesmentioning

confidence: 99%

Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes

Products¹

2014

EFS2

117

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Following a request from the Food Safety Authority of Ireland, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA Panel) was asked to deliver a scientific opinion on the evaluation of allergenic foods and food ingredients for labelling purposes. In view of the request, the NDA Panel decided to update its previous opinions relative to food ingredients or substances with known allergenic potential listed in Annex IIIa of 2003/89/EC, as amended. These include cereals containing gluten, milk and dairy products, eggs, nuts, peanuts, soy, fish, crustaceans, molluscs, celery, lupin, sesame, mustard and sulphites. The opinion relates to immunoglobulin (Ig)E-and non-IgE-mediated food allergy, to coeliac disease and to adverse reactions to sulphites in food, and it does not address non-immune-mediated adverse reactions to food. It includes information on the prevalence of food allergy in unselected populations, proteins identified as food allergens, cross-reactivities, the effects of food processing on the allergenicity of foods and ingredients, methods for the detection of allergens and allergenic foods, doses observed to trigger adverse reactions in sensitive individuals and risk assessment methodologies that have been used to derive individual and population thresholds for selected allergenic foods. The present opinion relates to immunoglobulin (Ig)E-and non-IgE-mediated food allergy, to coeliac disease and to adverse reactions to sulphites in food, and it does not address non-immune-mediated adverse reactions to food. For each food ingredient or substance listed in Annex IIIa, it includes information on the prevalence of food allergy in unselected populations, on proteins identified as food allergens, on cross-reactivities, on the effects of food processing on the allergenicity of foods and ingredients, on methods for the detection of allergens and allergenic foods, and on doses observed to trigger adverse reactions in sensitive individuals.Immune-mediated adverse reactions to foods manifest with clinical signs and symptoms of variable severity and duration, which may affect different organs and systems. Anaphylactic reactions to food are IgE mediated and may occur at any age. Non-IgE-mediated food allergy includes a wide range of diseases, including protein-induced enterocolitis and eosinophilic oesophagitis.A careful family and clinical history are the basis for diagnosis of food allergy. Food diaries, skin prick tests (SPTs), allergen-specific IgE measurements, food elimination diets and food challenges are part of the standard protocol for the diagnosis of food allergy. A positive SPT indicates sensitisation to the tested food, but it is not diagnostic of food allergy. Allergen-specific serum IgE antibodies similarly denote sensitisation to a particular food, but they are not diagnostic without a clinical history or food challenge. The use of atopy patch tests for the diagnosis of food allergy is controversial. Other available tests have no current role in the diagnosis of food allergy. Diag...

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“…Son frecuentes los antecedentes personales y familiares de atopia, especialmente en los pacientes más jóvenes (16,17), y se han comunicado casos de incidencia familiar (19,20). Con frecuencia se describe su aparición en atletas bien entrenados (3,21). Cualquier tipo de ejercicio ha sido implicado, desde actividades deportivas intensas hasta otras más moderadas, si bien se asocia más frecuentemente con ejercicios aeróbicos como el jogging y la marcha rápida (18).…”

Section: Epidemiologíaunclassified

Síndrome de anafilaxia inducida por ejercicio

Pimiento

Parra

Montoya

et al. 2001

An. Med. Interna (Madrid)

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INTRODUCCIÓNEl incremento gradual de las prácticas deportivas en la sociedad actual, junto con la alta prevalencia de la patología alérgica en los sectores de la población con mayor actividad física, ha supuesto la aparición de síndromes de trasfondo alérgico, en ocasiones subclínicos, que sólo se manifiestan con el ejercicio (1,2) (Tabla I). Entre estos cuadros clínicos destaca por su potencial gravedad la anafilaxia inducida por ejercicio (AIE), que constituye una forma peculiar de anafilaxia conocida desde hace tan sólo dos décadas pero que se observa cada vez con mayor frecuencia.La anafilaxia inducida por ejercicio (AIE) fue descrita por primera vez por Maulitz en 1979 (3) en un corredor de fondo que sufría reacciones anafilácticas recurrentes de intensidad variable al practicar ejercicio tras la ingestión de marisco.Poco después, Sheffer y Austen (4) establecerían sus características definitorias, considerándola como una forma de alergia física severa que puede ser provocada por cualquier tipo 49 [0212-7199(2001) RESUMENEn las dos últimas décadas se ha observado una incidencia creciente de una forma peculiar de anafilaxia que sólo se produce al realizar ejercicio físico. Dentro del síndrome de anafilaxia inducida por ejercicio se incluyen dos formas clínicas bien diferenciadas: urticaria colinérgica sistémica y anafilaxia inducida por ejercicio propiamente dicha, que se puede presentar en su forma clásica o en su forma variante, más infrecuente y con manifestaciones similares a la urticaria colinérgica. La anafilaxia postprandial inducida por ejercicio o dependiente de alimentos constituye un subtipo frecuentemente identificado en estos últimos casos. Puede deberse a una alergia alimentaria subclínica que se manifiesta con el esfuerzo, aunque en muchas ocasiones no es posible encontrar un alergeno responsable. El diagnóstico se establece por la historia clínica y la realización de pruebas específicas con alergenos alimentarios. Puede ser necesario recurrir a una prueba de esfuerzo con y sin ingesta previa. El tratamiento es preventivo y se basa en evitar la comida o el alimento responsable de la alergia en las horas previas a la realización del ejercicio. Cuando no depende de alimentos se recurre a farmacoterapia profiláctica con antihistamínicos, cromonas o bicarbonato sódico. El paciente debe ser instruido sobre el uso de adrenalina en caso de nuevas reacciones.PALABRAS CLAVE: Anafilaxia inducida por ejercicio. Anafilaxia inducida por ejercicio dependiente de alimentos. Hipersensibilidad alimentaria. ABSTRACTIn

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Exercise-induced anaphylactic reaction to shellfish

Cited by 320 publications

References 5 publications

About the role and underlying mechanisms of cofactors in anaphylaxis

About the role and underlying mechanisms of cofactors in anaphylaxis

Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes

Síndrome de anafilaxia inducida por ejercicio

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