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

Aihara, Yukoh; Takahashi, Yuriko; Kotoyori, Takeshi; Mitsuda, Toshihiro; Ito, Reiko; Aihara, Michiko; Ikezawa, Zenrō; Yokota, Shumpei

doi:10.1067/mai.2001.119914

Cited by 128 publications

(89 citation statements)

References 17 publications

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“…The low concordance between sensitization and provocation tests could be explained either by cross-reactivity with house dust mite (HDM) and other arthropod allergens, or by the presence of additional factors, the so-called trigger factors, able to elicit clinical symptoms, e.g., higher allergen concentration, physical exercise, alcohol, and/or anti-inflammatory drugs intake. This makes it difficult to identify a relationship between symptoms and laboratory data [7,8,9,10]. The major shrimp allergen is tropomyosin (TM), which shares a high sequence homology with all crustaceans, molluscs, HDM, and cockroaches [11].…”

Section: Introductionmentioning

confidence: 99%

Mite-Induced Asthma and IgE Levels to Shrimp, Mite, Tropomyosin, Arginine Kinase, and Der p 10 Are the Most Relevant Risk Factors for Challenge-Proven Shrimp Allergy

Farioli

Losappio²,

Giuffrida

et al. 2017

Int Arch Allergy Immunol

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Background: Shrimp sensitization is common in the general population, but the presence of symptoms is only moderately related to sensitization. A point still at issue is which in vivo and/or in vitro tests (food challenge, component-resolved diagnosis, house dust mite [HDM] sensitization) can help in distinguishing shrimp-allergic subjects from subjects that are sensitized but tolerant. Methods: The aim of this study was to evaluate the role of IgE to the different shrimp and mite allergens in distinguishing shrimp challenge-positive from challenge-negative patients. Subjects with suspected hypersensitivity reactions to shrimp, positive skin prick tests (SPTs), and/or anti-shrimp IgE were submitted to open and double-blind placebo-controlled food challenges (DBPCFC). Specific IgE to shrimp, mites, and the recombinants rPen a 1, rDer p 1, 2, and 10 were tested using ImmunoCAP-FEIA. IgE immunoblotting was performed to identify the patients' allergenic profiles. Results: In total, 13 out of 51 (25.5%) patients with reported reactions to shrimp were truly shrimpallergic (7 DBPCFC positive and 6 with documented severe reactions). These patients had significantly higher skin test wheal diametersthan nonallergic patients,as well as higher levels of IgE to rPen a 1 and rDer p 10. HDM-induced asthma and thesimultaneous presence of anti-nDer p 1, 2, and 10 IgE levels increased the risk of true shrimp allergy. Conclusion: Food challenge tests are mandatory for the diagnosis of shrimp allergy. Tropomyosin is associated with clinical reactivity. HDM-induced asthma and anti-mite IgE are risk factors for shrimp allergy.

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Section: Introductionmentioning

confidence: 99%

Mite-Induced Asthma and IgE Levels to Shrimp, Mite, Tropomyosin, Arginine Kinase, and Der p 10 Are the Most Relevant Risk Factors for Challenge-Proven Shrimp Allergy

Farioli

Losappio²,

Giuffrida

et al. 2017

Int Arch Allergy Immunol

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“…Increased intestinal permeability may be the basis, but the mechanisms involved are still unclear [74,82]. The best characterized is wheat-dependent exercise-induced anaphylaxis in patients sensitized to omega-5-gliadin [83,84]. NSAIDs seem to enhance allergic reactions to plant foods in patients sensitized to LTPs [62,85].…”

Section: Factors Influencing the Occurrence And/or Severity Of Symptomsmentioning

confidence: 99%

Which Foods Cause Food Allergy and How Is Food Allergy Treated?

Fernández‐Rivas

Asero

2014

Risk Management for Food Allergy

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“…This protocol takes the form of a double-blinded, placebo-controlled food exercise challenge. 8 The patient is asked to ingest the suspected food allergen and then exercise on a treadmill according to a Bruce protocol. The value of this test is, however, limited with only a 70% positive predictive value, 8 so a negative challenge does not rule out the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…8 The patient is asked to ingest the suspected food allergen and then exercise on a treadmill according to a Bruce protocol. The value of this test is, however, limited with only a 70% positive predictive value, 8 so a negative challenge does not rule out the diagnosis. In addition, the challenge test is labour-intensive and, like other diagnostic challenge scenarios in clinical allergy practice, potentially exposes the patient to risk; consequently, it is little used.…”

Section: Discussionmentioning

confidence: 99%

Lessons about food anaphylaxis

Medveczky

2014

Clinical Medicine

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A Lessons about food anaphylaxisExercise-induced anaphylaxis (EIA) and its subtype fooddependent (FD)-EIA are uncommon and easily missed forms of physical allergy. The latter is triggered by exercise following the ingestion of specifi c food products. Treatment is identical to that for IgE-mediated allergic reactions. The disease is potentially fatal. In this case, 30-year-old woman was seen in the allergy clinic at the request of her general practitioner. She reported an episode when she had gone to a local park to exercise after dinner. Shortly thereafter, she collapsed with rash, lip swelling, and breathing diffi culties. Upon admission to hospital, she was found to be hypotensive and required fl uid resuscitation, systemic corticosteroids and adrenaline. She made a full and uneventful recovery. On the basis of the clinical story and specifi c allergy markers, her presentation was attributed to FD-EIA. KEYWORDS:Exercise-induced anaphylaxis, histamine, collapse, physical allergy, urticaria Case presentationA 30-year-old woman, who had previously been fi t and well and with no history of diseases of the atopic diathesis (eczema, allergic rhinitis, food allergy or asthma) was referred to the allergy clinic after an episode of collapse associated with breathing diffi culties shortly after dinner. She reported that on the day of the collapse, she invited friends for a meal. The dinner consisted of tapas, including dairy, pasta, prawns, and red wine. After the meal, she decided to go for a run in a nearby park. She left the house within 1.5 hours of eating and started to run gently. Within minutes, she felt unwell. She gave a description of developing a generalised pruritic rash followed shortly by lip swelling, which rapidly progressed to audible wheeze and breathing diffi culties. A friend accompanying her in the park reported that she became pale and complained of colicky abdominal pain. Thereafter, she collapsed without losing consciousness. An ambulance was called, and upon arrival of the paramedics, she was found to be signifi cantly cold, sweaty, and with low blood pressure, thus requiring rapid intravenous fl uid challenge. She was transferred to a local emergency department, where further resuscitation

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

Cited by 128 publications

References 17 publications

Mite-Induced Asthma and IgE Levels to Shrimp, Mite, Tropomyosin, Arginine Kinase, and Der p 10 Are the Most Relevant Risk Factors for Challenge-Proven Shrimp Allergy

Mite-Induced Asthma and IgE Levels to Shrimp, Mite, Tropomyosin, Arginine Kinase, and Der p 10 Are the Most Relevant Risk Factors for Challenge-Proven Shrimp Allergy

Which Foods Cause Food Allergy and How Is Food Allergy Treated?

Lessons about food anaphylaxis

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