title: Evaluation of systemic allergy in a jet aviator.
abstract: Cholinergic urticaria and exercise-induced anaphylaxis (EIA) are related conditions. Cholinergic urticaria is caused by a rise in body core temperature and usually results in pruritus, skin lesions and, rarely, in serious respiratory and cardiovascular compromise. EIA can result in a cardiovascular compromise and syncope. Ingestion of certain foods may be associated with EIA. A 41-year-old jet pilot complained of 3-month onset of pruritus and urticaria during treadmill exercise. On one occasion, after a routine exercise bout, albeit with pruritus and urticaria, he experienced two short episodes of syncope. Treatment with a nonsedating H1-receptor antagonist was started. He underwent a unique challenge test that we designed. This included passive warming as well as exercising in a hot (temperature of 40 degrees C at 40% humidity) environment. After passing this test uneventfully, the pilot was returned to jet flight with a copilot and, subsequently, to full active duty.
authors.affiliation: Israel Aeromedical Center, Israel Air Force, Tel Hashomer, Israel. carterd@zahav.net.il
authors.forename: Dan
authors.initials: D
authors.lastname: Carter
authors.forename: Alon
authors.initials: A
authors.lastname: Grossman
authors.forename: Russell
authors.initials: R
authors.lastname: Pokroy
authors.forename: Bela
authors.initials: B
authors.lastname: Azaria
authors.forename: Liav
authors.initials: L
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D000707:Anaphylaxis / Q000209:etiology; D001831:Body Temperature; D015444:Exercise; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D007159:Immunologic Tests / Q000379:methods*; D008297:Male; D013575:Syncope / Q000209:etiology
chemical_list: D039563:Histamine H1 Antagonists, Non-Sedating