Food-dependent exercise-induced anaphylaxis (FDEIA) is a distinct form of immunoglobulin E–mediated food allergy in which symptoms occur only when ingestion of the culprit food is followed by exercise or another cofactor, such as nonsteroidal anti-inflammatory drugs. We report an adolescent girl with recurrent FDEIA in whom stepwise food-exercise challenge testing identified Muscat grape as the most likely trigger despite negative routine in vitro testing. This case highlights the importance of stepwise provocation testing when FDEIA is suspected.
Tanimura et al. (Wed,) studied this question.