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Exercise induced anaphylaxis in kiwi allergic patient: case report
Natalia Ukleja-Sokołowska1, Robert Zacniewski2, Kinga Lis2
1Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, ul. Ujejskiego 75, 85-168, Bydgoszcz, Poland. ukleja@10g.pl.
Summary
Exercise can trigger severe kiwi allergies, even in individuals without prior reactions. This case highlights food-dependent exercise-induced anaphylaxis, emphasizing the need for awareness in allergy diagnosis.
Area of Science:
- Allergy and Immunology
- Clinical Medicine
- Exercise Physiology
Background:
- Kiwi allergy is uncommon in Poland, with oral allergy syndrome (OAS) being the most frequent manifestation.
- Systemic reactions to kiwi allergy are reported in 18-28% of allergic individuals.
- Exercise can act as a cofactor in allergic reactions.
Purpose of the Study:
- To report a rare case of food-dependent exercise-induced anaphylaxis to kiwi.
- To investigate the role of exercise in precipitating a severe allergic reaction to kiwi.
- To highlight the diagnostic challenges and implications of kiwi sensitization.
Main Methods:
- A case study of a 27-year-old male with no prior chronic diseases.
- Diagnostic evaluation included component-resolved diagnostics (CRD) and an oral food challenge (OFC) with kiwi.
- The OFC was performed both at rest and after an exercise provocation test.
Main Results:
- The patient developed anaphylactic symptoms including lip swelling, hives, and weakness after consuming kiwi post-exercise.
- Component-resolved diagnostics confirmed sensitization to grass allergen components (Phl p 1, 2, 5) and kiwi (Act d 2).
- The oral food challenge was positive only after exercise, confirming food-dependent exercise-induced anaphylaxis.
Conclusions:
- This is the first reported case of exercise as a necessary cofactor for anaphylaxis in a kiwi-allergic patient.
- The findings underscore the importance of considering exercise as a trigger in food-dependent anaphylaxis.
- Accurate diagnosis requires a thorough patient history and specific diagnostic testing, including exercise provocation.
