Abstract
The patient was a 14-year-old boy who had previously experienced urticaria or anaphylaxis following ingestion of PL granules®(Salicylamide, acetaminophen, anhydrous caffeine, a methylene disalicylic acid promethazine combination) or ibuprofen in conjunction with Japanese noodles. In February 2008, anaphylaxis occurred while he was playing soccer after eating a school lunch. The school lunch menu consisted of milk, oden (Japanese potaufeu containing Japanese radish, eggs, hanpen (fish paste), konjac (yam paste), carrots, spinach, chikuwa (fish paste)), seaweed mixed rice and fried fish.
His diagnosis was suspected with Food-dependent exercise-induced anaphylaxis due to the wheat because of positive specific IgE antibody (ImmunoCAP®)to wheat, gluten and his past history. But in challenge test, wheat with exercise elicited no symptoms. So he was given aspirin before wheat, anaphylaxis was induced without exercise.This finding suggested that the symptoms had been elicited by simultaneous ingestion of wheat and a salicylic acid-containing substance, from which wheat-dependent salicylic acid-induced anaphylaxis was diagnosed.
