TY - JOUR
T1 - Food-Dependent Exercise-Induced Anaphylaxis
T2 - A Distinct Form of Food Allergy—An Updated Review of Diagnostic Approaches and Treatments
AU - Srisuwatchari, Witchaya
AU - Kanchanaphoomi, Kantima
AU - Nawiboonwong, Jutamard
AU - Thongngarm, Torpong
AU - Sompornrattanaphan, Mongkhon
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/10
Y1 - 2023/10
N2 - Food-dependent exercise-induced allergic reactions (FDEIA) represent a distinct clinical phenomenon where symptoms arise during exercise following the consumption of specific trigger foods, with the most severe manifestation being anaphylaxis—a condition distinct from typical exercise-induced or food-induced anaphylaxis. In FDEIA, patients can either exercise or tolerate specific foods separately without experiencing any allergic reactions. Diagnosis relies on patient history and provocation testing, requiring rigorous implementation within a supervised hospital environment. Positive symptoms and clinical signs during testing confirm FDEIA, while negative outcomes do not preclude its presence. Exercise stands as the primary trigger, followed by nonsteroidal anti-inflammatory drugs (NSAIDs) and alcohol. The utilization of various protocols for food cofactor challenges to confirm FDEIA yields differing diagnostic outcomes. We highlight the updated concept of food cofactor challenges, incorporating protocols reported in the literature, and summarize current recommendations and comprehensive management approaches for FDEIA patients.
AB - Food-dependent exercise-induced allergic reactions (FDEIA) represent a distinct clinical phenomenon where symptoms arise during exercise following the consumption of specific trigger foods, with the most severe manifestation being anaphylaxis—a condition distinct from typical exercise-induced or food-induced anaphylaxis. In FDEIA, patients can either exercise or tolerate specific foods separately without experiencing any allergic reactions. Diagnosis relies on patient history and provocation testing, requiring rigorous implementation within a supervised hospital environment. Positive symptoms and clinical signs during testing confirm FDEIA, while negative outcomes do not preclude its presence. Exercise stands as the primary trigger, followed by nonsteroidal anti-inflammatory drugs (NSAIDs) and alcohol. The utilization of various protocols for food cofactor challenges to confirm FDEIA yields differing diagnostic outcomes. We highlight the updated concept of food cofactor challenges, incorporating protocols reported in the literature, and summarize current recommendations and comprehensive management approaches for FDEIA patients.
KW - IgE
KW - anaphylaxis
KW - challenge test
KW - food allergy
KW - food-dependent exercise-induced anaphylaxis
KW - gluten
KW - oral food challenge
KW - provocation test
UR - http://www.scopus.com/inward/record.url?scp=85175162407&partnerID=8YFLogxK
U2 - 10.3390/foods12203768
DO - 10.3390/foods12203768
M3 - Review article
AN - SCOPUS:85175162407
VL - 12
JO - Foods
JF - Foods
IS - 20
M1 - 3768
ER -