ANAPHYLAXIS INDUCED BY EXERCISE AND RELATED TO MULTIPLE FOOD-INTAKE

In some patients, exercise-induced anaphylactic (EIAn) reactions occur only when a particular food is eaten before exercise. We describe thr ee patients with EIAn induced by different foods, Patients who present ed episodes of EIAn performed exercise challenges after fasting and 1 hour after a meal without foods suspected of predisposing the reaction . Subsequently, patients performed exercises after separate intake of each suspected food. Patients underwent skin prick tests (SPT) with fo od extracts. Serum total and specific IgE antibodies to food were dete rmined No reactions were provoked by exercise tests without prior inta ke of suspected foods. Eight of 30 food-exercise combination challenge s were positive. In Patient I, tomato, zucchini, and wheat resulted in adverse reactions; in Patient 2, potato, peanuts, and tomato; in Pati ent 3, rice and peanuts. SPTs and RASTs to foods predisposing the reac tion were positive. Food-exercise combined challenge may be useful in identifying foods that favor EIAn in children with multiple food-depen dent EIAn.