94 1 8 2018 doi:10.20776/s03035476-94-1-p1 2017 6 272017 8 18 food-dependent exercise-induced anaphylaxis FDEIA FDEIAFDEIA 2013 4 2016 3 FDEIA 1527 8 10 37 8 FDEIA FDEIA 3 3 2 1 1 IgE 876/7 3 IgE FDEIA Key words: prick to prick test Ⅰ fooddependent exercise-induced anaphylaxis FDEIA 1FDEIA 2,3 FDEIA 2,4,5 3,6,7 2 Ryo Fujimoto, Yoshinori Morita, Izumi Kato, Toshiaki Jibiki, Masaki Kanazawa and Masaru Terai. Clinical features of children with suspected food-dependent exercise-induced anaphylaxis. Department of Pediatrics, Chiba Kaihin Municipal Hospital, Chiba 261-0012. Phone: 043-277-7711. Fax: 043-278-7482. E-mail: rf.fr.rf@gmail.com Received June 27, 2017, Accepted August 18, 2017.
2 Ⅱ 2013 4 2016 3 FDEIA IgEImmunoCAP Thermo Fisher Scientific prick to prick test 3 6-8 1 3 60 10 /500 30 Bruce 5 15 180 / 2 : 2016-4 Ⅲ 2013 4 2016 3 30 17 17 12 8 1 3 4 2 3 1527 FDEIA 1 15 1 1
FDEIA 3 1 8 10 : 11 6 15 10 6 13 : 5 : 3 6 : 4 Total IgE IU/: 309 130 1249 580 90 1961 5 7 4 4 1 3 1 2 FDEIA 2 15 10 1527 2 10 37 2 8 FDEIA 2 9 : 10: 15 1 5 15 3 3 2 2 IgE 10 7 6 5 4 3 2 1 0 2 FDEIA 8 7 6 5 4 3 2 1 0 3 IgE 676/9 866/7 4 1 15 707/10 201/5 1
4 2 IgE IgE UA/ Prick to prick test ASA 1 11 265 0.77 0.10 2 10 208 0.100.10 3 11 1177 0.34 4 12 352 1.10 5 15 173 6 6 1249 0.71 69.4 79.1 5 3.34 0.24 2.61 7 11 130 58.0 36.8 34.6 8 7 975 5.60 975 5.60 9 13 596 10.7 10 13 1961 0.10 0.16 11 12 563 0.61 12 7 1111 0.50 13 10 280 0.52 14 8 497 0.10 0.10 50.10 15 10, 90,, : ASA: 100 % 80 60 40 20 0 6 67% 7 70% 6 87% 1 20% N=9 N=10 N=7 N=5 4 3 27 10 10 6 5 4 4 1 0
FDEIA 5 5 Ⅳ 4 3 2 1 0 15 15 30 30 45 5 45 60 3 10 5 5 60 8 2 9 FDEIA 10 FDEIA 8 1 2 2 11 FDEIA 13 7 FDEIA FDEIA 1527 27 8 10FDEIA 1 9 FDEIA 4 3 1 10 Asaumi FDEIA20 5 25 2 FDEIA 60 3FDEIA Asaumi FDEIA FDEIA Asaumi FDEIA Asaumi 2 2 1 FDEIA FDEIA 9,10FDEIA FDEIA FDEIA FDEIA - 5 3,6,11 2 FDEIA
6 3 2 8 FDEIA IgE 7,12 2 FDEIA 12 FDEIA prick to prick test 13 prick to prick test 14 prick to prick test FDEIA NSAIDs 2,15-17 23 85 2012 18 2016 1 19 1 2 FDEIA FDEIA 3 FDEIA prick to prick test
FDEIA 7 V FDEIA FDEIA prick to prick test 206 2017 2 SUMMARY Background Food-dependent exercise-induced anaphylaxis FDEIA is a distinct type of food allergy in which symptoms are induced by exercise after intake of the allergenic food. It is often difficult to specifically determine the allergenic food; even if determined, the proportion of positive findings on provocation tests is not necessarily high. Objective We investigated the clinical features of patients with suspected FDEIA. Methods In total, 15 patients undergoing 27 provocation tests were assessed retrospectively. The results of provocation and skin prick tests, suspected foods, and the titer of specific IgE ImmunoCAP Thermo Fisher Scientific were evaluated. Results We diagnosed 8 patients with FDEIA, based on the provocation tests. The allergenic foods were shrimp 3 cases, fruits 3 cases, soybean 2 cases, wheat 1 case, and mollusks 1 case. Specific IgE titers were not different between patients displaying positive results and those displaying negative results on provocation tests. Skin prick tests revealed a high positive rate in patients displaying positive results on provocation tests, including three patients negative for specific IgE. Conclusion Various foods are responsible for FDEIA in children. Skin prick tests are efficient in ascertaining certain suspected foods before performing provocation tests. 1 2016 2016. 2 Asaumi T, Yanagida N, Sato S, Shukuya A, Nishino M, Ebisawa M. 2016 Provocation tests for the diagnosis of food-dependent exerciseinduced anaphylaxis. Pediatr Allergy Immunol 27, 44-9. 3 Kohno K, Matsuo H, Takahashi H, Niihara H, Chinuki Y, Kaneko S, et al. 2013 Serum gliadin monitoring extracts patients with false negative results in challenge tests for the diagnosis of wheat-dependent exercise-induced anaphylaxis. Allergol Int 62, 229-38. 4 Kleiman J, Ben-Shoshan M. 2014 Fooddependent exercise-induced anaphylaxis with negative allergy testing. BMJ Case Rep 1-3. 5 Morita E, Matsuo H, Chinuki Y, Takahashi H, Dahlström J, Tanaka A. 2009 Food-dependent exercise-induced anaphylaxis -importance of omega-5 gliadin and HMW-glutenin as causative antigens for wheat-dependent exercise-induced anaphylaxis. Allergol Int 58, 493-8. 6 Asero R, Jimeno L, Barber D. 2008 Componentresolved diagnosis of plant food allergy by SPT. Eur Ann Allergy Clin Immunol 40, 115-21. 7 Klemans RJ, van Os-Medendorp H, Blankestijn M, Bruijnzeel-Koomen CA, Knol EF, Knulst AC. 2015 Diagnostic accuracy of specific IgE to components in diagnosing peanut allergy: a systematic review. Clin Exp Allergy 45, 19-39. 8 Scala G, Miceli Sopo S. 2015 When are serum specific IgE levels positive? J Allergy Clin Immunol 135, 291-2. 9 2015 1 64 149-55. 10 Takamatsu N, Kondo Y, Tsuge I, Nakajima Y, Naruse N, Tanaka K, et al. 2016 A study of cross-reactivity between citrus fruit and pollen allergens in oral allergy syndrome and fooddependent exercise-induced anaphylaxis in Japan. Fujita Med J 2, 6-11. 11 Morita E, Kunie K, Matsuo H. 2007 Fooddependent exercise-induced anaphylaxis. J Dermatol Sci 47, 109-17. 12 Brockow K, Kneissl D, Valentini L, Zelger O, Grosber M, Kulger C, et al. 2015 Using a gluten oral food challenge protocol to improve diagnosis of wheat-dependent exercise-induced anaphylaxis. J Allergy Clin Immunol 135, 977-84.e4. 13 Rosen J, Selcow J, Mendelson L, Grodofsky M, Factor J, Sampson H. 1994 Skin testing with natural foods in patients suspected of having food allergies: Is it a necesssity? J Allergy Clin Immunol 93, 1068-70. 142015 MB Derma 229, 35-40.
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