2017 Volume 31 Issue 1 Pages 46-52
Food-dependent exercise-induced anaphylaxis (FDEIA) has many unresolved problems from diagnosis to treatment. In this review, we aimed to show a clinical course and practical diagnostic points of FDEIA based on our experience.
An exercise-provocation test is essential for diagnosis and patient and parents'understanding of the pathophysiology of FDEIA. However, due to its low reproducibility, it is difficult to deny the diagnosis completely even if it is negative. Aspirin is sometimes used when exercise-provocation test is negative, but it should be carried out under sufficient preparation because it increases the risk of inducing anaphylaxis.
Specific IgE to ω-5 gliadin is useful for a diagnosis of wheat-dependent exercise-induced anaphylaxis in adult patients, but there are no identified components predictive of symptoms in children. A skin prick test using heated peach is useful in the diagnosis of peach FDEIA, and Pru p 7 (peamaclein) could be a component related to systemic reactions to peach.
