eMedicine Specialties > Pediatrics: General Medicine > Allergy & Immunology
Exercise-Induced Anaphylaxis: Differential Diagnoses & Workup
Updated: May 8, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Other Problems to Be Considered
Cholinergic urticaria
Idiopathic anaphylaxis
Exercise-induced asthma
Vocal cord dysfunction
Mastocytosis
Workup
Laboratory Studies
- Serum histamine levels are increased during anaphylactic episodes, including exercise-induced anaphylaxis (EIA). Increased serum tryptase levels have been reported in some patients.
- In one study, laboratory tests included assessments of whole-complement activity (CH50), C3 and C4 complement proteins, immunoglobulin classes, and blood chemistries; results were within the reference range.
Imaging Studies
- No imaging studies are routinely recommended.
Other Tests
- Radioallergosorbent testing (RAST), allergy skin testing, food-challenge testing, exercise-challenge testing, exercise food–challenge testing, and methacholine-challenge testing all are potential ways to obtain valuable information about patients suspected of having EIA.
Procedures
- No procedures are routinely recommended.
More on Exercise-Induced Anaphylaxis |
| Overview: Exercise-Induced Anaphylaxis |
Differential Diagnoses & Workup: Exercise-Induced Anaphylaxis |
| Treatment & Medication: Exercise-Induced Anaphylaxis |
| Follow-up: Exercise-Induced Anaphylaxis |
| References |
| Further Reading |
| « Previous Page | Next Page » |
References
Maulitz RM, Pratt DS, Schocket AL. Exercise-induced anaphylactic reaction to shellfish. J Allergy Clin Immunol. Jun 1979;63(6):433-4. [Medline].
Lee JY, Yoon S, Ye YM, Hur GY, Kim S, Park HS. Gliadin-specific IgE in wheat-dependent exercise-induced anaphylaxis. Allergy Asthma Proc. Nov-Dec 2008;29(6):614-21. [Medline].
Gangemi S, Mistrello G, Roncarolo D, Amato S, Minciullo PL. Pomegranate-dependent exercise-induced anaphylaxis. J Investig Allergol Clin Immunol. 2008;18(6):491-2. [Medline].
Orhan F, Karakas T. Food-dependent exercise-induced anaphylaxis to lentil and anaphylaxis to chickpea in a 17-year-old boy. J Investig Allergol Clin Immunol. 2008;18(6):465-8. [Medline].
Adachi A, Horikawa T, Shimizu H, et al. Soybean beta-conglycinin as the main allergen in a patient with food-dependent exercise-induced anaphylaxis by tofu: food processing alters pepsin resistance. Clin Exp Allergy. Jan 2009;39(1):167-73. [Medline].
Sheffer AL, Austen KF. Exercise-induced anaphylaxis. J Allergy Clin Immunol. Aug 1980;66(2):106-11. [Medline].
Soyer OU, Sekerel BE. Food dependent exercise induced anaphylaxis or exercise induced anaphylaxis?. Allergol Immunopathol (Madr). Jul-Aug 2008;36(4):242-3. [Medline].
Kjaer BN, Laursen LC. [Food-dependent exercise-induced anaphylaxis]. Ugeskr Laeger. Dec 1 2008;170(49):4058. [Medline].
Gani F, Selvaggi L, Roagna D. [Exercise-induced anaphylaxis]. Recenti Prog Med. Jul-Aug 2008;99(7-8):395-400. [Medline].
Castells MC, Horan RF, Sheffer AL. Exercise-induced anaphylaxis (EIA). Clin Rev Allergy Immunol. Winter 1999;17(4):413-24. [Medline].
Castells MC, Horan RF, Sheffer AL. Exercise-induced Anaphylaxis. Curr Allergy Asthma Rep. Jan 2003;3(1):15-21. [Medline].
Dice JP. Physical urticaria. Immunol Allergy Clin North Am. May 2004;24(2):225-46, vi. [Medline].
Gonzalez-Quintela A, Vidal C, Gude F. Alcohol, IgE and allergy. Addict Biol. Sep-Dec 2004;9(3-4):195-204. [Medline].
Hosey RG, Carek PJ, Goo A. Exercise-induced anaphylaxis and urticaria. Am Fam Physician. Oct 15 2001;64(8):1367-72. [Medline].
Ii M, Sayama K, Tohyama M, Hashimoto K. A case of cold-dependent exercise-induced anaphylaxis. Br J Dermatol. Aug 2002;147(2):368-70. [Medline].
Joint Task Force on Practice Parameters. The diagnosis and management of anaphylaxis: an updated practice parameter. J Allergy Clin Immunol. Mar 2005;115(3 Suppl 2):S483-523. [Medline].
Kutting B, Brehler R. Exercise-induced anaphylaxis. Allergy. Jun 2000;55(6):585-6. [Medline].
Lashley M, Klein N. Exercise-induced anaphylaxis in a 4-year-old boy. Ann Allergy. Apr 1990;64(4):381-2. [Medline].
Longo G, Barbi E, Puppin F. Exercise-induced anaphylaxis to snails. Allergy. May 2000;55(5):513-4. [Medline].
Matsuo H, Morimoto K, Akaki T, et al. Exercise and aspirin increase levels of circulating gliadin peptides in patients with wheat-dependent exercise-induced anaphylaxis. Clin Exp Allergy. Apr 2005;35(4):461-6. [Medline].
Morimoto K, Hara T, Hide M. Food-dependent exercise-induced anaphylaxis due to ingestion of apple. J Dermatol. Jan 2005;32(1):62-3. [Medline].
Morimoto K, Tanaka T, Sugita Y, Hide M. Food-dependent exercise-induced anaphylaxis due to ingestion of orange. Acta Derm Venereol. 2004;84(2):152-3. [Medline].
Novembre E, Cianferoni A, Bernardini R, et al. Anaphylaxis in children: clinical and allergologic features. Pediatrics. Apr 1998;101(4):E8. [Medline]. [Full Text].
Perez-Calderon R, Gonzalo-Garijo MA, Fernandez de Soria R. Exercise-induced anaphylaxis to onion. Allergy. Aug 2002;57(8):752-3. [Medline].
Perkins DN, Keith PK. Food- and exercise-induced anaphylaxis: importance of history in diagnosis. Ann Allergy Asthma Immunol. Jul 2002;89(1):15-23. [Medline].
Senna G, Mistrello G, Roncarolo D, et al. Exercise-induced anaphylaxis to grape. Allergy. Dec 2001;56(12):1235-6. [Medline].
Shadick NA, Liang MH, Partridge AJ, et al. The natural history of exercise-induced anaphylaxis: survey results from a 10-year follow-up study. J Allergy Clin Immunol. Jul 1999;104(1):123-7. [Medline].
Tilles S, Schocket A, Milgrom H. Exercise-induced anaphylaxis related to specific foods. J Pediatr. Oct 1995;127(4):587-9. [Medline].
Volcheck GW, Li JT. Exercise-induced urticaria and anaphylaxis. Mayo Clin Proc. Feb 1997;72(2):140-7. [Medline].
Further Reading
- Relevant clinical guidelines include the following:
- Relevant clinical trials include the following:
- Related eMedicine topics include the following:
Keywords
exercise-induced anaphylaxis, EIA, food-dependent exercise-induced anaphylaxis, drug-dependent exercise-induced anaphylaxis, medicine-dependent exercise-induced anaphylaxis, physical urticaria, pruritus, NSAIDs, shock, hypotension, anaphylaxis syndrome, nausea, cramping, diarrhea, vomiting, tinnitus, vertigo, pruritus, difficulty breathing, chest tightness, treatment, diagnosis
Differential Diagnoses & Workup: Exercise-Induced Anaphylaxis