[A CASE OF INDUCIBLE LARYNGEAL OBSTRUCTION REQUIRED DIFFERENTIATION FROM FOOD-DEPENDENT EXERCISE-INDUCED ANAPHYLAXIS]

A 9-year-old girl with a history of stridor and pharyngeal strangury was developed during exercise. The patient was diagnosed with food dependent exercise-induced anaphylaxis (FDEIA) because stridor occurred after wheat ingestion and exercise provocation test at the age of ten. Although the patient restricted intake of wheat before exercise, stridor and disturbance of consciousness occurred after exercise and did not respond to adrenaline injection. We suspected exercise-induced anaphylaxis or exercise-induced laryngeal obstruction. Although the patient restricted exercise, similar symptoms occurred even with psychological anxiety and nervousness. Laryngoscopy at the age of eleven during an attack revealed vocal cord closure on inhalation and the patient was diagnosed with inducible laryngeal obstruction (ILO). The symptoms of ILO are similar to the respiratory symptoms of FDEIA in some aspects, but the main symptom is stridor and not responsive to treatment. Appropriate diagnosis of ILO could avoid induction of symptoms and inappropriate treatment.