Allergy, Asthma & Respiratory Disease  2015;3(3):224-227

doi:10.4168/aard.2015.3.3.224

Apple-dependent exercise-induced anaphylaxis.

Dong Hyun KIM 1 ; Kyung Hee PARK ; Young Joo KIM ; Jun Ho KIM ; Hee Jae HAN ; Hye Jung PARK ; Jung Won PARK ; Jae Hyun LEE

Affiliations

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Keywords

Anaphylaxis; Food hypersensitivity; Immunoblotting

Country

Republic of Korea

Language

Korean

Abstract

Food-dependent exercise-induced anaphylaxis (FDEIA) is a specific variant of anaphylaxis that requires both vigorous physical activity and the ingestion of specific causative foods. In particular, occurrence for FDEIA is rarely associated with apples. A 17-year-old male experienced generalized urticaria, dyspnea, headache, vomiting, and presyncope after ingestion of an apple and then 2 hours of exercise. The skin prick test showed a strong positive reaction to apple crude allergen extract, whereas the results of an open food challenge and exercise provocation tests were negative. However, the exercise test after apple consumption provoked a positive reaction with generalized urticaria, dyspnea, and presyncope. We detected 17 kD IgE-reactive protein band in immunoblotting assay with apple crude extract and patient's serum.