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Food-dependent exercise-induced anaphylaxis to pistachio
S Porcel1, A B Sánchez, E Rodríguez
1Allergy Department, Complejo Hospitalario de Cáceres, Cáceres, Spain. seporcel@yahoo.es
Summary
A teenager experienced anaphylaxis after eating pistachios and exercising. This rare case of food-dependent exercise-induced anaphylaxis to pistachio was diagnosed via a specific food exercise challenge test.
Area of Science:
- Allergy and Immunology
- Exercise Physiology
Background:
- Food-dependent exercise-induced anaphylaxis (FDEIA) is a rare condition.
- Diagnosis can be challenging due to negative standard allergy tests.
Observation:
- A 16-year-old male presented with anaphylaxis post-pistachio ingestion and football.
- Standard allergy tests (skin prick, IgE) for pistachio were negative.
- Exercise challenges without food were also negative.
Findings:
- A specific food exercise challenge, 60 minutes after pistachio ingestion, triggered anaphylaxis.
- This confirmed pistachio as the trigger for FDEIA in this patient.
- This is the first reported case of FDEIA specifically to pistachio.
Implications:
- Highlights the importance of specific food exercise challenges for diagnosing FDEIA.
- Suggests non-IgE mediated mechanisms may be involved in some FDEIA cases.
- Expands the spectrum of known food triggers for exercise-induced anaphylaxis.
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