A Case of Spaghetti-dependent Exercise-induced Anaphylaxis that was Suggested to have been Caused by a Water-soluble Albumin Antigen

Abstract

　We report the case of a 17-year-old male student who exhibited wheat-dependent exercise-induced anaphylaxis after consuming frozen spaghetti. The final diagnosis was made because the patient developed anaphylactic symptoms during exercise after consuming aspirin and spaghetti. He did not experience such symptoms after he ate bread and then rode to school by bicycle. A prick test for wheat flour (Torii) produced a positive reaction, and prick-to-prick tests for bread wheat (weak flour and strong flour) and durum wheat flour also produced strong positive reactions. A test for wheat flour-specific IgE was positive, but tests for gluten-, ω-5 gliadin-, and high-molecular-weight glutenin-specific IgE were negative. Immunoblot analysis using bread wheat and durum wheat flour revealed several intense bands around 40 kDa, 50 kDa, 60 kDa, and 28-30 kDa in the lane for durum wheat flour. Further analysis revealed a protein band at approximately 60 kDa in the lane for water-soluble albumin, which was suggested to be the causative antigen in this case.