2023 Volume 37 Issue 2 Pages 177-180
This article describes the major changes in the section on food-dependent exercise-induced anaphylaxis (FDEIA) in the 2021 Japanese Guidelines for Food Allergy based on the 2016 guidelines.
The 2016 guidelines defined FDEIA as a "disease" in which anaphylaxis is induced by exercise after ingestion of certain foods. However, in clinical practice, we often experience a patient with FDEIA suffering from allergic symptoms that are triggered by cofactors other than exercise or when at rest. In recent years, several important studies have been reported in relation to the pathogenesis of FDEIA. These studies have shown that exercise is one of the factors that can lower the symptom elicitation threshold for immediate-type food allergies, and that patients thought to have FDEIA can have their symptoms triggered by factors other than exercise. Based on these findings, the 2021 guidelines define FDEIA as a "condition" in which anaphylaxis is triggered by exercise exertion after ingestion of certain foods.
