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Published on: October 14, 2014
Exercise-induced urticaria, angioedema, and anaphylactoid episodes
The Journal of Allergy and Clinical Immunology
|December 1, 1981
Summary
Exercise-induced anaphylactoid reactions present with diverse skin symptoms. Systemic symptoms like hypotension correlate with elevated plasma histamine levels, but not with skin-only manifestations.
Area of Science:
- Allergy and Immunology
- Dermatology
- Exercise Physiology
Background:
- Exercise-induced anaphylactoid reactions are a spectrum of allergic responses triggered by physical activity.
- Manifestations can range from cutaneous symptoms to severe systemic reactions.
Purpose of the Study:
- To characterize the clinical presentation of exercise-induced anaphylactoid symptoms.
- To investigate the correlation between specific symptoms and plasma histamine levels.
Main Methods:
- Exercise challenge tests were performed on six subjects with a history of exercise-induced anaphylactoid symptoms.
- Plasma histamine levels and serum complement (C'3, C'4) were measured.
- Clinical manifestations during exercise were meticulously recorded.
Main Results:
- Five subjects experienced symptoms during exercise, including periorbital angioedema, giant urticaria with wheeze and hypotension, and cholinergic urticaria.
- Two subjects with hypotension showed elevated plasma histamine levels (11.2 and 23.2 ng/ml).
- Subjects with only cutaneous symptoms did not exhibit elevated plasma histamine; complement levels remained normal.
Conclusions:
- Exercise-induced anaphylactoid reactions manifest with varied cutaneous symptoms like angioedema, giant urticaria, and cholinergic urticaria.
- Elevated plasma histamine is indicative of systemic involvement, specifically when accompanied by hypotension.
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