A Case of Mite-Ingestion-Associated Exercise-Induced Anaphylaxis Mimicking Wheat-Dependent Exercise-Induced Anaphylaxis

作者：Adachi Yoko S; Itazawa Toshiko; Okabe Yoshie; Higuchi Osamu; Ito Yasunori; Adachi Yuichi

来源：International Archives of Allergy and Immunology, 2013, 162(2): 83-85.

DOI：10.1159/000351778

• Exercise-induced anaphylaxis
• Food allergy
• Mite allergy

We present a case of mite-ingestion-associated exercise-induced anaphylaxis mimicking wheat-dependent exercise-induced anaphylaxis (WDEIA). A 17-year-old boy was referred for an episode of anaphylaxis while jogging, 1.5 h after having eaten okonomiyaki (a Japanese pancake). Laboratory measures revealed a slightly elevated specific immunoglobulin E (IgE) antibody against omega-5 gliadin (0.41 kU(A)/l) and a marked elevation of specific IgE antibody against house-dust mite, Dermatophagoides farinae (142 kU(A)/l). A detailed interview revealed that, in spite of the referring doctor%26apos;s advice to discontinue postprandial exercises, he continued his jogging routine after consuming foods containing wheat and also that his younger brother, who had mild intermittent asthma, had suffered a mild asthma attack 2 h after eating the same food. We therefore examined the okonimiyaki mix, which had been stored for several months after opening the package until this episode, under a microscope, and we found an abundant number of live mites, D. farinae. Finally, a diagnosis of mite-ingestion-associated exercise-induced anaphylaxis was made. This clinical entity should be excluded when making a diagnosis of WDEIA.

• 出版日期2013