[Three cases of food-dependent exercise-induced anaphylaxis]

A variety of systemic reactions associated with exercise are recognized. This article describes three cases of anaphylaxis induced by exercise within 2 hours after the ingestion of causative foods. Their symptoms were urticaria, angioedema, bronchial asthma, fall in blood pressure and syncope. Cases #1 and #3 showed exercise-induced anaphylaxis after ingestion of wheat. However, case #1 reacted only to toasted wheat. In case #2 the most likely responsible food was also wheat, although we could not definitely confirm this. Two subjects exhibited an elevation in plasma histamine level when symptoms developed. In addition, we observed inhibition of these symptoms by pretreatment with anti-allergic drugs. These observations suggest that type I allergic reaction is involved in the development of these symptoms. However, why exercise combined with ingestion of food is needed for this type of anaphylaxis still remains unknown.