Food-Dependent, Exercise-Induced Anaphylaxis

SYSTEMIC anaphylactic reactions are rare consequences of the ingestion of certain foods, administration of drugs, or exposure to stinging insects. Recently, exercise has been recognized as an additional cause of anaphylaxis.1The entity of exercise-induced anaphylaxis has been further modified by the recognition that in some susceptible persons, exercise must be preceded or followed by the ingestion of any food or of specific foods for anaphylaxis to occur.2,3 This report concerns a patient with food-dependent, exercise-induced anaphylaxis. The patient underwent exercise challenge both with and without prior food ingestion; plasma histamine determinations were performed during and after exercise. Report of a Case A 24-year-old woman was initially seen in July 1982 for evaluation of an episode of pruritus, urticaria, angioedema, abdominal cramping, and diarrhea, accompanied by impending loss of consciousness. This episode began after the patient had jogged 1 mile in 20 minutes. Despite symptoms, the patient was