Abstract
Food-dependent salicylate-induced anaphylaxis (FDSIA) is a type of anaphylaxis caused by the simultaneous ingestion of a substance that contains salicylic acid and a causative food. We report on an FDSIA patient (male, 58 years old) who suffered anaphylaxis as a result of simultaneous ingestion of wheat and acetylsalicylic acid. This patient experienced wheals 3 or 4 times a year after ingestion of bread, Chinese noodles, hamburger, etc. The patient visited this department because of systemic wheals and dyspnea that occurred after ingestion of buckwheat noodles on April 2008. According to the laboratory test findings, the IgE RAST for wheat and gluten were assessed as class 2 and class 3, respectively. After treatment comprising a drip infusion of steroid and oral administration of an antiallergy drug, the symptoms remitted. When a loading test was conducted on another day, no anaphylaxis was induced by wheat ingestion + exercise loading and aspirin ingestion alone. However, when he ingested wheat after aspirin intake, systemic wheals and erythema occurred after 1 hour. Since IgE that is specific to ω-5 gliadin was found in the serum, our patient was diagnosed as having FDSIA caused by wheat.
