title: [A case of food-dependent exercise-induced anaphylaxis associated with repeated episodes of syncope].
abstract: This report describes a patient with food-dependent exercise-induced anaphylaxis (FEA). A 25-year-old female has had three episodes of syncopal attack associated with urticaria in the past two years: the attacks have been developed by exercise after taking meals made of wheat flour. She has an allergic predisposition to metals. No abnormal findings were observed in the routine work up for syncope including, ECG, 24-hour Holter ECG, UCG, tilt table test, and EEG examinations. A provocative test for FEA was performed. It included food (sandwich) intake followed by exercise. The serum histamine concentration was elevated to a three times higher than the control value after the provocation. Accordingly, she was diagnosed as FEA and advised not to take wheat flour prior to physical exercise. No syncopal episode has been observed during the 16 months since the diagnosis.
authors.affiliation: Department of Emergency Medicine, School of Medicine, Keio University.
authors.forename: H
authors.initials: H
authors.lastname: Tashiro
authors.forename: S
authors.initials: S
authors.lastname: Hori
authors.forename: Y
authors.initials: Y
authors.lastname: Shinozawa
authors.forename: K
authors.initials: K
authors.lastname: Obara
authors.forename: S
authors.initials: S
authors.lastname: Fujishima
authors.forename: Y
authors.initials: Y
authors.lastname: Miyata
authors.forename: J
authors.initials: J
authors.lastname: Namiki
authors.forename: J
authors.initials: J
authors.lastname: Koizumi
authors.forename: J
authors.initials: J
authors.lastname: Sasaki
authors.forename: T
authors.initials: T
authors.lastname: Hirata
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000175:diagnosis / Q000209:etiology*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D005512:Food Hypersensitivity / Q000150:complications*; D006632:Histamine / Q000097:blood; D006801:Humans; D012008:Recurrence; D013575:Syncope / Q000209:etiology*
chemical_list: D006632:Histamine