Exercise-Related Allergic Diseases

Jae Won Jeong

doi:10.5763/kjsm.2014.32.1.1

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Jeong: Exercise-Related Allergic Diseases

Review Article

Korean J Sports Med 2014;32(1):1-6.

Published online: 17 January 2014

DOI: https://doi.org/10.5763/kjsm.2014.32.1.1

Exercise-Related Allergic Diseases

Jae Won Jeong

Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Korea

Correspondence: Jae Won Jeong Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, 170 Juhwa-ro, Ilsanseo-gu, Goyang 411-706, Korea Tel: +82-31-910-7202, Fax: +82-31-910-7219 E-mail: jeong_jaewon@hanmail.net

Received 14 April 2014 Revised 15 April 2014 Accepted 15 May 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Allergic diseases are common in sports athletes, as they are in the general population. Any physician who involved in the care of athletes will commonly face the management of allergic conditions. Exercise-aggravated or exercise-induced allergic disorders are significant health problems to competitive athletes, although the majority of these disorders are mild and symptomatically annoying, several allergic diseases carry the risk of anaphylaxis and even sudden death. Meticulous approach in the diagnosis and management of allergic conditions is essential for the sports medicine physicians to afford all athletes can compete safely with their highest physical and mental level.

Keywords: Asthma, Anaphylaxis, Urticaria, Exercise-induced

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Fig. 1.

Lung function change in exercise induced asthma patient after exercise provocation test. FEV1: forced expiratory volume in 1 second.

Table 1.

Diagnostic exercise required to obtain approval from the Medical Comission (MC) of the International Olympi Committee (IOC) for the use of inhaled β2-agonists

Diagnostic procedure	Results as required by IOC-MC
Clinical history of respiratory symptoms and clinical examination	Positive clinical history
Lung function (spirometry or maximum expiratory flow volume loops)	Increase in FEV₁ after inhaled bronchodilator
Reversibility to inhaled bronchodilator
Exercise induced bronchoconstriction by standardized exercise test	FEV₁ decrease of 10% from before to after
	standardized exercise challenge
Bronchial hyperresponsiveness to methacholine (histamine presently	PD20<2 mol, PC20<4 mg/mL
not allowed by IOC-MC)	Other values when on inhaled steroids
Eucapnic hyper ventilation test or Mannitol inhalation test (Aridol test)	Reduction in FEV₁ of 15% or more
	Reduction in FEV₁ of 15% or more
	Determination of PD15 of mannitol
Exercise field test	Reduction in FEV₁ of 10% or more

FEV1: forced expiratory volume in 1 second, PD20: provocative dose causing a 20% drop in FEV1, PC20: provocativ concentration causing a 20% drop in FEV1.

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