Successful Prophylaxis of Wheat-Dependent Exercise-Induced Anaphylaxis with Terfenadine.

Abstract

A 20-year-old female was brought to our emergency unit with generalized erythema and discomfort induced by running after having eaten wheat bread. The laboratory examinations, including eosinophils, total IgE, RASTscore to wheat, heat challenge test and methacholine inhalation test were within normal limits. No anaphylactoid responses occurred after provocation tests of wheat bread intake or exercise alone. However,on provocation exercise test after eating pancakes, she developed hypotension, generalized itching and urticaria associated with an elevation of plasma histamine levels. These findings suggested wheat-dependent exercise-induced anaphylaxis. This was completely prevented by daily administration of terfenadine 120 mg p.o. without side effects such as fatigue or drowsiness. (Internal Medicine 34: 654-656, 1995)

Food-Dependent Exercise-Induced Anaphylaxis: A Case Related to Chickpea Ingestion and Review

“…In an acute attack, antihistamines, corticosteroids, and/or epinephrine can be used depending on the severity of the symptoms. Currently, there are no approved prophylactic agents for FDEIA, although case reports have described various possibilities including sodium bicarbonate, disodium cromoglycate, and terfenadine [27-29]. …”

Acute Liver Injury That Followed Food-Dependent Exercise-Induced Anaphylaxis.

“…To prevent FDEIAn, prophylactic use of anti-histamine has been reported (29). Werecommendedthat the patient does not to do exercise for three hours after eating wheat-containing foods and subsequently, there has been no sign of FDEIAnfor the last six years.…”

Exercise-Induced Anaphylaxis: A Food-Dependent Variant

“…22,[24][25][26][27][28] Reports of 6 cases suggest that some medications may prevent FDEIA symptoms, even after ingesting a trigger food prior to exercise (Table 3). In 2 cases, no FDEIA recurrences were experienced during the 6-12 months that followed the intervention.…”