Food-dependent exercise-induced anaphylaxis occurred only in a warm but not in a cold environment.
Food-dependent exercise-induced anaphylaxis (FDEIA) is a type of exercise-induced anaphylaxis associated with postprandial exercise. We describe a 19-year-old man with FDEIA. Our patient complained of urticaria, angioedema, dizziness and hypotension associated with exercise after ingestion of walnut-containing foods in a warm environment. Skin prick test and prick to prick test were positive for walnut antigen. The attack didn't occur by free running outside for 10 min 2 h after taking walnuts, and the temperature was about -2℃. Food-exercise test was done again in a warm environment based on prior history. Anaphylaxis was developed after exercise for 10 min in a warm environment after taking walnuts. Some environmental factors such as high temperature and high humidity or cold temperature may influence exercise-induced anaphylaxis. In our case, the cofactor was a warm environment: the challenge test done in a cold environment was negative, but positive in a warm environment. Physicians should be aware that the challenge test of FDEIA can show different results depending on temperature.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea.
Eun-Jung
EJ
Jo
Min-Suk
MS
Yang
Yoon-Jeong
YJ
Kim
Hyun-Suk
HS
Kim
Mi-Yeong
MY
Kim
Sae-Hoon
SH
Kim
Sang-Heon
SH
Cho
Kyung-Up
KU
Min
Yoon-Seok
YS
Chang