Journal List > Pediatr Allergy Respir Dis > v.22(1) > 1033163

Pang, No, Kim, Lee, Lee, Kim, Lee, Lee, Hong, and Kim: A Case Report of Food-Dependent Exercise-Induced Anaphylaxis in a Patient who was Sensitive to Pork

Abstract

Food-dependent exercise-induced anaphylaxis (FDEIA) is a specific variant of exercise-induced anaphylaxis that requires both vigorous physical activity and the ingestion of specific foods. In particular, it is rare occurrence for FDEIA to be associated with meat in Korea. A 15-year-old female had generalized urticaria, dyspnea, severe cough, headache, dizziness, and vomiting after singing and dancing for 1 hour and after ingesting grilled pork. Skin prick tests showed a strong positive reaction to pork, whereas the results of an oral food challenge and exercise provocation tests were negative. However, the exercise provocation test after pork ingestion showed a positive reaction manifested by generalized urticaria, cough, mild dyspnea, and a 23% decreased peak expiratory flow rate. Three allergens to pork (67 kDa, 90 kDa, and 15 kDa) reacted with the patient's serum on immunoglobulin E immunoblotting. We report a case of pork-dependent exercise-induced anaphylaxis in a patient who was sensitive to pork.

Figures and Tables

Fig. 1
Plain chest X-ray shows hyperinflation in both lungs.
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Fig. 2
Sodium dodecyl sulfate polyacrylamide gel electrophoresis analysis of pork treated with heating (10 %). M, molecular weight marker; Lane 1, raw boston butt; Lane 2, boiled boston butt; Lane 3, roasted boston butt; Lane 4, raw boned rib; Lane 5, boiled boned rib; Lane 6, roasted boned rib.
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Fig. 3
Imunoglobulin E Immunoblotting of pork. M, molecular weight marker; Lane 1, raw boston butt; Lane 2, boiled boston butt; Lane 3, roasted boston butt; Lane 4, raw boned rib; Lane 5, boiled boned rib; Lane 6, roasted boned rib.
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Table 1
Results of Multiple Allergen Simultaneous Test
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Class 0, non-detectable; Class 1, low; Class 2, increased; Class 3, significantly increased; Class 4, high; Class 5, very high; Class 6, extremely high.

Table 2
Results of Allergen Skin Prick Test
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1+, R<1, wheal 1-2 mm, erythema<21 mm; 2+, R<1, wheal 1-3 mm, erythema≧21 mm; 3+, 1≦R<2, wheal 3-5 mm, erythema≧21 mm; 4+, 2≦R<3, wheal >5 mm, erythema≧21 mm; R, allergen/histamine.

Table 3
Results of Exercise Provocation Test after Ingestion of Pork
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