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Food-dependent exercise-induced anaphylaxis in Japanese elementary school children.

Tetsuharu Manabe1,2, Norihiro Oku1,3, Yukoh Aihara4

  • 1Department of Pediatrics, Kanagawa Prefectural Ashigarakami Hospital, Matsuda, Kanagawa, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|January 18, 2018
PubMed
Summary

Food-dependent exercise-induced anaphylaxis (FDEIA) is less common in elementary students than junior-high students. Wheat is the primary trigger, and a new form of anaphylaxis (DEIA) was observed.

Keywords:
desensitizationelementary school childrenepidemiologyfood-dependent exercise-induced anaphylaxisoral immunotherapy

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Area of Science:

  • Pediatric Allergy and Immunology
  • Epidemiology
  • Food Hypersensitivity

Background:

  • Food-dependent exercise-induced anaphylaxis (FDEIA) prevalence was previously established at 0.018% in Yokohama junior-high students.
  • A distinct condition, desensitization status and exercise-induced anaphylaxis (DEIA), was noted in a post-oral immunotherapy case.
  • Limited epidemiological data exists for FDEIA in elementary school populations.

Purpose of the Study:

  • To determine the frequency and characteristics of FDEIA in elementary school children in Yokohama.
  • To compare FDEIA prevalence in elementary school children with that of junior-high school students.
  • To identify common causative foods and observe any new patterns of exercise-induced anaphylaxis.

Main Methods:

  • A questionnaire survey was distributed to 348 public elementary school nurses in Yokohama.
  • Response rate was 91.1% (317 nurses).
  • Children with a history of immediate food allergy achieving desensitization via oral immunotherapy were classified as DEIA, not FDEIA.

Main Results:

  • FDEIA prevalence was found to be 0.0047% in elementary school children, significantly lower than in junior-high students (P = 0.0009).
  • Wheat was the most frequent causative food for FDEIA (n=4), followed by soy, fruit, crustaceans, and squid.
  • Four cases of DEIA were identified, with wheat and milk as causative agents (n=2 each).

Conclusions:

  • FDEIA is significantly less prevalent in elementary school children compared to junior-high students.
  • Wheat is the predominant food trigger for FDEIA in this age group.
  • The emergence of DEIA is a noteworthy finding, and addressing recurrent episodes requires further attention.