title: [Exercise-induced anaphylaxis].
abstract: Exercise-induced anaphylaxis is a mast cell dependent reaction, which is induced by allergen exposure in combination with physical activity. Typically, the reaction occurs within 2 hours after allergen exposure followed by physical activity. Not only food allergens but all kinds of allergens including drugs can induce this form of anaphylaxis. The clinical symptoms of exercise-induced anaphylaxis are the same as in any other type of anaphylaxis. Thus not only the skin and mucosa but also other organ systems like the lungs, cardiovascular system and gastrointestinal tract can be affected. The diagnostic work up should cover a detailed clinical history including the assessment of symptoms and possible trigger factors including suspected allergens. Besides classical allergy diagnostics like skin prick tests and specific IgE determination, tryptase should be measured for the differential diagnosis to exclude mast cell dependent diseases. The diagnosis of exercise-induced anaphylaxis is made by the means of a double-blind placebo-controlled provocation test. Both, a sufficient amount of allergen and of physical activity must be achieved for a valid test. After the diagnosis is made, patients should be extensively counseled and provided with an emergency kit including an epinephrine auto injector.
authors: Klinik für Dermatologie, Venerologie und Allergologie, Allergie-Centrum-Charité, Charité-Universitätsmedizin Berlin.
authors: K
authors: K
authors: Wylon
authors: S
authors: S
authors: Hompes
authors: M
authors: M
authors: Worm
mesh_terms: D000465:Algorithms; D000485:Allergens / Q000276:immunology; D000707:Anaphylaxis / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D000918:Antibody Specificity / Q000276:immunology; D018849:Controlled Clinical Trials as Topic; D003937:Diagnosis, Differential; D004311:Double-Blind Method; D015444:Exercise; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007428:Intradermal Tests; D008407:Mast Cells / Q000276:immunology
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
references: Br J Dermatol. 1998 May;138(5):898-900
references: 9666843
references: Allergy. 2012 May;67(5):691-8
references: 22335765
references: Asia Pac J Public Health. 1994;7(1):26-30
references: 8074941
references: Clin Exp Allergy. 2009 Jul;39(7):1036-44
references: 19302258
references: Ann Allergy Asthma Immunol. 2001 Nov;87(5):412-6
references: 11730184
references: Int Arch Allergy Immunol. 2001 Jul;125(3):264-72
references: 11490160
references: J Allergy Clin Immunol. 2001 Dec;108(6):1035-9
references: 11742285
references: J Immunol. 2005 Dec 15;175(12):8116-22
references: 16339549
references: Allergy. 2012 Nov;67(11):1451-6
references: 23004029
references: Am J Vet Res. 2010 Oct;71(10):1207-13
references: 20919909
references: J Dermatol Sci. 2007 Aug;47(2):109-17
references: 17507204
references: J Allergy Clin Immunol. 1991 Jan;87(1 Pt 1):34-40
references: 1991921
references: J Dtsch Dermatol Ges. 2013 Jan;11(1):44-50
references: 23181736
references: Ital J Pediatr. 2012 Sep 14;38:43
references: 22980517
references: Allergy. 1995 Oct;50(10):817-24
references: 8607564
references: Br J Dermatol. 2002 Mar;146(3):466-72
references: 11952547
references: Br J Dermatol. 2001 Aug;145(2):336-9
references: 11531805
references: J Allergy Clin Immunol. 1979 Jun;63(6):433-4
references: 447945