title: [Case of food-dependent exercise-induced anaphylaxis diagnosed by the provocation test with cuttlefish after the pretreatment with 1.5 g of aspirin].
abstract: A 29-year-old woman had an episode of urticaria at the age of 17 while exercising after eating fried cuttlefish. For years thereafter, she experienced several episodes of urticaria after eating seafood. At the age of 29, she ate grilled seafood, including cuttlefish for supper after taking loxoprofen for lumbago. One hour later, she developed generalized urticaria accompanied by nausea, abdominal pain, swelling of the lips, and dyspnea while walking; she was taken to a hospital. She was then referred to us for further examination of the etiology of her anaphylactic reactions. The level of specific IgE measured using Immuno CAP was negative for all kinds of foods, including cuttlefish. However, a skin prick test was positive for raw and cooked cuttlefish. Provocation tests were performed on admission by combining the intake of cuttlefish and aspirin under the suspicion of cuttlefish allergy enhanced by nonsteroidal anti-inflammatory drugs and exercise. As a result, she developed no symptoms except for slight itching of the oral mucosa after eating 20 g or 100 g of cuttlefish with or without concomitant administration of 0.5 g of aspirin. Finally, generalized urticaria appeared after challenge with cuttlefish and 1.5 g of aspirin. She was diagnosed with food-dependent exercise-induced anaphylaxis (FDEIA) caused by cuttlefish. She has not developed urticaria since she started to avoid eating cuttlefish. Our results indicated that in provocation tests for the diagnosis of FDEIA, allergic reactions could not only be induced by food intake but could also be enhanced by aspirin in a dose-dependent manner.
authors.affiliation: Department of Dermatology, Yokohama City University School of Medicine.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Nakamura
authors.forename: Naoko
authors.initials: N
authors.lastname: Inomata
authors.forename: Tomoko
authors.initials: T
authors.lastname: Okawa
authors.forename: Nobuko
authors.initials: N
authors.lastname: Maeda
authors.forename: Mio
authors.initials: M
authors.lastname: Kirino
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shiomi
authors.forename: Zenro
authors.initials: Z
authors.lastname: Ikezawa
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000175:diagnosis* / Q000276:immunology; D000818:Animals; D001241:Aspirin / Q000008:administration & dosage* / Q000276:immunology*; D049832:Decapodiformes / Q000276:immunology*; D004306:Dose-Response Relationship, Immunologic; D015444:Exercise / Q000502:physiology*; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D007159:Immunologic Tests / Q000379:methods
chemical_list: D001241:Aspirin