Exercise-induced allergy

Although the pathogenesis of exercise-induced allergy (EIA) is poorly understood, biopsy studies have demonstrated mast cell degranulation after exercise. Patient s with EIA who have specific foods as coprecipitating factors invariably have positive skin test reactions to these foods, thus specific IgE mast cell sensitization is indicated. A potential dysfunction in the autonomic nervous system has also been hypothesized. Differential diagnosis includes cholinergic urticaria. 

Sheffer AL. Austen KF Exercise-induced anaphylaxis. J Allergy Clin Immunol 1980 66 106. 

The role of atopy in anaphylaxis has not completely been resolved. On the one hand there is for example no evidence of a higher risk of severe reactions in venom-allergic patients. A recent study by Sturm et al. [38] indicated that patients with high total IgE levels predominantly developed mild to moderate reactions. By contrast, atopy may increase the risk and severity of systemic reactions in beekeepers and their family numbers [39]. On the other hand, atopy and in particular allergic asthma are risk factors for food allergy and therefore are also important risk factors for food-induced anaphylaxis. This is most likely also true for exercise-induced anaphylaxis, but also non-IgE-dependent anaphylaxis induced by NSAIDs or contrast media. 

Croizier A, Baudouin E, Bihain B, Moneret-Vautrin DA Interest of ImmunoCAP system to recombi- 34 nant omega-5 ghadin for the diagnosis of exercise-induced wheat allergy Int Arch Allergy Immunol 2008 149 74-80. 

Only nine allergic reactions to cuttlefish have been described (Caffarelli et ah, 1996 Ebisawa et ah, 2003 Shibasaki et ah, 1989). One patient was a 10-year-old female who experienced a severe reaction to ingestion of cuttlefish that was manifested by urticaria, angioedema, asthma, abdominal pain, laryngeal edema, and hypotension (Shibasaki et ah, 1989). SPT and RAST were positive. This patient reportedly tolerated octopus, clam, oyster, abalone, mussel, and scallop but reacted to crab and shrimp. Caffarelli et ah (1996) describe a 14-year-old female who had cuttlefish-dependent, exercise-induced anaphylaxis. Ebisawa et ah (2003) reported 7 cases of allergy to cuttlefish among a series of 305 pediatric cases of food allergy but provided no specifics on the circumstances or symptoms of these patients. 

H. Food-dependent, exercise-induced molluscan shellfish allergy... 

Dohi, M., Suko, M., Sugiyama, H., Yamashita, N., Tadokoro, K., Juji, F., Okudaira, H., Sano, Y., Ito, K., and Miyamoto, T. (1991). Food-dependent, exercise-induced anaphylaxis A study on 11 Japanese cases. /. Allergy Clin. Immunol. 87, 34- 0. 

Longo, G., Barbi, E., and Puppin, P. (2000). Exercise-induced anaphylaxis to snails. Eur. ]. Allergy Clin. Immunol. 55, 513-514. 

Maulitz, R. M., Pratt, D. S., and Schocket, A. L. (1979). Exercise-induced anaphylactic reaction to shellfish. /. Allergy Clin. Immunol. 63, 433M34. 

Palosuo, K., Alenius, H., Varjonen, E., Koivuluhta, M., Mikkola, J., Keskinen, H., Kalkkinen, N., Reunala, T. 1999. A novel wheat gliadin as a cause of exercise-induced anaphylaxis. J Allergy Clin Immunol 103 912-917. 

Hawksworth RJ, Sykes AP, Faris M, Mant T, Lee TH. Albuterol HFA is as effective as albuterol CFC in preventing exercise-induced bronchoconstriction. Ann Allergy Asthma Immunol 2002 88(5) 473-7. 

McPaddenER Jr. Exercise-induced airway narrowing. In Adkinson Jr NF, Ytmginger JW, Busse WW, et al, eds. Middleton s Allergy Principles and Practice, 6th ed. St Louis, Mosby, 2003 1323-1332. 

Stoke, C. L. 2001. A computer model of chronic asthma with application to clinical studies Example of treatment of exercise-induced asthma. J Allergy Clin Immunol 107 933. 

Noma T, Yoshizawa I, Ogawa N, Ito M, Aoki K, Kawano Y (2001). Fatal buckwheat dependent exercised-induced anaphylaxis. Asian Pac. J. Allergy Immunol, 19 283-286. 

Studies are being undertaken to determine the efficacy of lodoxamide tromethamine in exercise induced bronchospasm, allergic rhinitis and various skin allergies. 

Romano, A., Di Fonso, M., Giuffreda, F., Papa, G., Artesani, M.C., Viola, M., Venuti, A., Palmieri, V., and Zeppilli, R, Food-dependent exercise-induced anaphylaxis Clinical and laboratory findings in 54 subjects, Int. Arch. Allergy Immunol, 125, 264-272, 2001. 

Belcher, N. G., Murdoch, R., Dalton, N., Clark, T. J. H., Ress, P. J., and Lee, T. H., 1988, Circulating concentrations of histamine, neutrophil chemotactic activity, and catecholamines during the refractory period in exercise-induced asthma, J. Allergy Clin. Immunol 81 100-110. 

Sheffer, A. L., Soter, N. A., McFadden, E. R., and Austen, K. F., 1983, Exercise-induced anaphylaxis A distinct form of physical allergy, J. Allergy Clin. Immunol. 71 311-316. 

Anderson SD, Daviskas E. The mechanism of exercise-induced asthma is... J Allergy CUn Immunol 2000 106 453-459. 

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