Food-dependent Exercise-induced Anaphylaxis: The Need for Better Understanding and Management of the Disease

Jeong, Kyunguk

doi:10.4168/aair.2022.14.4.345

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…The importance of the exercise as a co-factor is so relevant as to be related to a specific nosological entity, that is Food-Dependent Exercise-Induced Anaphylaxis (FDEIA), a condition whereby the onset of anaphylaxis occurs during or soon after physical exercise preceded by ingestion of a food, while the food and exercise are tolerated separately ( 51 ). Some of these patients experience FDEIA after all meals followed by exercise, regardless of the food eaten, while in other cases the reaction occurs only in presence of specific allergens ( 52 ).…”

Section: The Role Of the Co-factors In Allergic Reactions To Nsltpsmentioning

confidence: 99%

“…In Italy nsLTPs represent the main allergens involved in such a category of anaphylaxis ( 3 , 52 ), but other food allergens might be involved ( 48 ). The pathological mechanism is probably due to the increase of the allergen absorption caused by the elevated blood circulation, with the subsequent increased transport of the allergen by blood flow redistribution during exercise from gut to tissues containing mast cells ( 51 , 53 ). Moreover, increased plasma noradrenaline levels might induce anaphylactoid manifestations ( 51 ).…”

Section: The Role Of the Co-factors In Allergic Reactions To Nsltpsmentioning

confidence: 99%

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Factors and co-factors influencing clinical manifestations in nsLTPs allergy: between the good and the bad

Ridolo,

Barone,

Ottoni

et al. 2023

Front. Allergy

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Non-specific lipid transfer proteins (nsLTPs) are a family of plant pan-allergens that represent the primary cause of food allergies in the Mediterranean area, characterized by a wide range of clinical manifestations, ranging from the total absence of symptoms up to anaphylaxis. This wide variety of symptoms is related to the intrinsic capacity of nsLTPs to cause an allergic reaction in a specific subject, but also to the presence of co-factors exacerbating (i.e., exercise, NSAIDs, PPIs, alcohol, cannabis, prolonged fasting, menstruation, acute infections, sleep deprivation, chronic urticaria) or protecting from (i.e., co-sensitization to PR10, profilin or polcalcin) severe reactions. In this picture, recognizing some nsLTPs-related peculiarities (i.e., route, type and number of sensitizations, concentration of the allergen, cross-reactions) and eventual co-factors may help the allergist to define the risk profile of the single patient, in order to promote the appropriate management of the allergy from dietary advices up to the prescription of life-saving epinephrine autoinjector.

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Section: The Role Of the Co-factors In Allergic Reactions To Nsltpsmentioning

confidence: 99%

Section: The Role Of the Co-factors In Allergic Reactions To Nsltpsmentioning

confidence: 99%

Factors and co-factors influencing clinical manifestations in nsLTPs allergy: between the good and the bad

Ridolo,

Barone,

Ottoni

et al. 2023

Front. Allergy

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Anaphylaxis

Abrams,

Alqurashi,

Fischer

et al. 2024

Allergy Asthma Clin Immunol

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Anaphylaxis is an acute, potentially fatal systemic hypersensitivity reaction with varied mechanisms and clinical presentations. Although prompt recognition and treatment of anaphylaxis are imperative, both patients and healthcare professionals often fail to recognize and diagnose its early signs. Clinical manifestations vary widely, however, the most common signs are cutaneous symptoms, including urticaria and angioedema. Immediate intramuscular administration of epinephrine into the anterolateral thigh is first-line therapy, and is always safe even if the diagnosis is uncertain. The mainstays of long-term management include specialist assessment, allergen avoidance measures, and the provision of an epinephrine auto-injector with an individualized anaphylaxis emergency plan. This article provides an overview of the causes, clinical features, diagnosis, and acute as well as long-term management of anaphylaxis.

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A case report of food-dependent exercise-induced anaphylaxis (FDEIA) treated with omalizumab

Mohamed,

Thalappil,

Mohamed Ali

2024

Front. Allergy

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Food-dependent exercise-induced anaphylaxis (FDEIA) is a rare and complex clinical condition in which allergic reactions are triggered by specific foods combined with physical activity, even though the food allergen and exercise are tolerated individually. Wheat is the most common culprit food leading to wheat dependent exercise induced anaphylaxis (WDEIA). Management of FDEIA is challenging due to the unpredictability of attacks and the lack of approved prophylactic medications. This report presents a case of successful symptom control in a young woman with WDEIA through the addition of omalizumab to the treatment regimen. To our knowledge, this is the first reported case of food-dependent exercise-induced anaphylaxis (FDEIA) treated with omalizumab as the primary indication. We also summarize the pathophysiology, diagnosis and treatment of FDEIA. The need for heightened awareness and innovative therapeutic approaches is crucial for those affected by FDEIA.

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Food-dependent Exercise-induced Anaphylaxis: The Need for Better Understanding and Management of the Disease

Cited by 3 publications

References 20 publications

Factors and co-factors influencing clinical manifestations in nsLTPs allergy: between the good and the bad

Factors and co-factors influencing clinical manifestations in nsLTPs allergy: between the good and the bad

Anaphylaxis

A case report of food-dependent exercise-induced anaphylaxis (FDEIA) treated with omalizumab

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