Allergy Asthma Respir Dis.  2013 Sep;1(3):203-210. 10.4168/aard.2013.1.3.203.

Food-dependent exercise-induced anaphylaxis in Korea: a multicenter retrospective case study

• Im JH
• Kwon HY
• Ye YM
• Park HS
• Kim TB
• Choi GS
• Kim JH
• Jang GC
• Kim MK
• Hur GY
• Koh YI
• Sohn SW
• Kim CW
• KAAACI Work Group for Urticaria/Angioedema/Anaphylaxis

• KMID: 2262961
• DOI: http://doi.org/10.4168/aard.2013.1.3.203

Abstract

PURPOSE
To investigate the causes, clinical features and characteristics of food-dependent exercise-induced anaphylaxis (FDEIA) in Korea.
METHODS
A retrospective medical chart review was performed on the patients diagnosed with anaphylaxis between 2007 and 2011 in 14 hospitals in Korea. Cases with FDEIA were subsequently identified among anaphylaxis patients, and subgroup analyses were done to assess clinical characteristics of FDEIA.
RESULTS
A total of 62 subjects with FDEIA (male, 72.6%; aged 16 to 70 years) were enrolled in 10 hospitals. Wheat (69.3%) was the most common cause of FDEIA, followed by meat (8.1%), seafood (6.5%), and vegetables (6.5%). The clinical manifestations were cutaneous (100%), respiratory (64.5%), cardiovascular (61.3%), and gastrointestinal (9.7%), respectively. In severity assessment, approximately 40% of FDEIA were classified as severe anaphylaxis. Portable epinephrine auto-injector was prescribed to 17.2% of patients, and about one fifth of the patients experienced redevelopment of anaphylactic symptoms during follow-up period. There was no significant difference of age, gender, latent period, total immunoglobulin E, and past history of allergic disease between patients with severe anaphylaxis group and patients with mild-to-moderate group.
CONCLUSION
Wheat is the most common cause of FDEIA in Korea. Because significant number of patients with FDEIA experienced anaphylactic symptoms after diagnosis of FDEIA, more comprehensive therapeutic and educational approaches will be required to prevent recurrent development of anaphylaxis.

Keyword

Food hypersensitivity; Exercise; Anaphylaxis

MeSH Terms

Aged
Anaphylaxis
Epinephrine
Follow-Up Studies
Food Hypersensitivity
Humans
Immunoglobulin E
Immunoglobulins
Korea
Meat
Retrospective Studies
Seafood
Triticum
Vegetables
Epinephrine
Immunoglobulin E
Immunoglobulins

Figure

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  Fig. 1. The number of patients diagnosed with food-dependent exercise-induced anaphylaxis from 2007 to 2011. Although small drop was noted in 2010, increased tendency in the number of patients diagnosed with food-dependent exercise-induced anaphylaxis was observed during this period.

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  Fig. 2. The causative foods for patients with food-dependent exercise-induced anaphylaxis. Wheat was the most common cause of food-dependent exercise-induced anaphylaxis in Korea.

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