The necessity for dual food intake to provoke food-dependent exercise-induced anaphylaxis (FEIAn): A case report of FEIAn with simultaneous intake of wheat and umeboshi

Food-dependent exercise-induced anaphylaxis

“…Induction of anaphylaxis has clearly been demonstrated to be dependent on the amount of allergen ingested by the patient with wheat-dependent exercise-induced anaphylaxis (WDEIA) [15]. Specific combinations of food intake may be necessary for allergy induction in some FDEIA cases in provoking their symptoms [16]. Fatigue, cold, and lack of sleep appeared to affect the development of the anaphylactic symptoms [17].…”

Exercise-induced anaphylaxis

“…Foods implicated included crustacea (shrimp and crab), wheat, vegetables, and buckwheat. In one case, the development of anaphylaxis required the ingestion of two foods together prior to exercise (wheat and umeboshi) [7]. All patients were 9 years of age or older except for one patient who was 5 years of age.…”

“…In rare cases, dual food intake is necessary to induce EIA. One case has been reported of the association between wheat and umeboshi for the induction of EIA, neither of the two allergens alone being sufficient to trigger symptoms upon exercise [7].…”

Role of Adverse Reactions to Food in Urticaria and Exercise-Induced Anaphylaxis

“…These authors concluded that an insufficient amount of food allergen ingested or subthreshold exercise levels may be reasons for unsuccessful challenge tests noted in several previous reports [31]. On the other hand, Aihara et al [32] described a case of a 14-year-old boy who did not develop symptoms of FDEIA after ingestion of rice or ‘umeboshi’ (Japanese plum) alone but clearly after ingestion of the two foods together.…”