A case of wheat-dependent, exercise-induced aspirin-shock

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Allergol Int. 2008 Mar 1;57(1) [Epub ahead of print] Links

Food-Dependent Exercise-Induced Anaphylaxis Induced by Low Dose Aspirin Therapy.

Fujii H, Kambe N, Fujisawa A, Kohno K, Morita E, Miyachi Y.

Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto.

Background: Food-dependent exercise-induced anaphylaxis (FDEIA) is a distinct

form of

common food allergy characteristically induced by a combination of causative

food

ingestion and physical exercise. Recent investigations have documented that

aspirin

consumption, in place of exercise, also induces allergic symptoms. Case Summary:

A 63-

year-old man began low dose aspirin therapy on September 2005.

Since January 2006, he had repeated episodes of generalized urticaria and lost

consciousness while he was exercising after eating wheat.

He was strongly positive for omega-5 gliadin in a cap-system fluorescent enzyme

immunoassay. Therefore, a diagnosis of wheat-dependent exercise-induced

anaphylaxis

was made.

Discussion: Patients with aspirin-provoked FDEIA have been reported previously

as taking

ordinary doses of aspirin for reducing pain, inflammation and fever. However, in

our

patient, low dose aspirin therapy for reducing cardiovascular risk possibility

induced

FDEIA. Growing numbers of elderly people take low doses of aspirin for

prevention of

cerebral or myocardial infarction. Therefore, physicians should remember that

aspirin

consumption, even at low doses, is a risk factor for FDEIA.