Exercise-induced anaphylaxis: causes, consequences and management recommendations

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Abstract

INTRODUCTION: Exercise induced anaphylaxis (EIA) denotes a range of disorders where anaphylaxis occurs in relation to physical exercise. Typical symptoms include flushing, pruritus, urticaria, angioedema, respiratory symptoms, gastro-intestinal symptoms, hypotension, and collapse during or after exercise. The far best described entity within EIA is food-dependent exercise-induced anaphylaxis (FDEIA), where symptoms only occur in combination with food intake. Frequency and predictability of symptoms vary, and some patients experience symptoms only if exercise is accompanied by other co-factors Areas covered: In the present review, we aimed to provide an overview of EIA, diagnostic workup, causes, management and discuss areas in need of further research. Expert opinion: Though rare, EIA is an entity that all allergists and practicing physicians should recognize. The pathophysiological and immunological mechanisms of EIA are largely unknown. Management is centered upon avoidance of eliciting factors, where emergency plans are individualized, except a mandatory prescription of an adrenaline auto-injector.

Original languageEnglish
JournalExpert Review of Clinical Immunology
Volume15
Issue number3
Pages (from-to)265-273
ISSN1744-666X
DOIs
Publication statusPublished - Mar 2019

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Urticaria
Expert Testimony
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Food
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Keywords

  • Anaphylaxis
  • FDEIA
  • augmentation
  • co-factors
  • diagnosis
  • exercise
  • exercise induced anaphylaxis
  • food allergy
  • food dependent exercise induced anaphylaxis
  • management

Cite this

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title = "Exercise-induced anaphylaxis: causes, consequences and management recommendations",
abstract = "INTRODUCTION: Exercise induced anaphylaxis (EIA) denotes a range of disorders where anaphylaxis occurs in relation to physical exercise. Typical symptoms include flushing, pruritus, urticaria, angioedema, respiratory symptoms, gastro-intestinal symptoms, hypotension, and collapse during or after exercise. The far best described entity within EIA is food-dependent exercise-induced anaphylaxis (FDEIA), where symptoms only occur in combination with food intake. Frequency and predictability of symptoms vary, and some patients experience symptoms only if exercise is accompanied by other co-factors Areas covered: In the present review, we aimed to provide an overview of EIA, diagnostic workup, causes, management and discuss areas in need of further research. Expert opinion: Though rare, EIA is an entity that all allergists and practicing physicians should recognize. The pathophysiological and immunological mechanisms of EIA are largely unknown. Management is centered upon avoidance of eliciting factors, where emergency plans are individualized, except a mandatory prescription of an adrenaline auto-injector.",
keywords = "Anaphylaxis, FDEIA, augmentation, co-factors, diagnosis, exercise, exercise induced anaphylaxis, food allergy, food dependent exercise induced anaphylaxis, management",
author = "Christensen, {Morten J} and Esben Eller and Kjaer, {Henrik F} and Sigurd Broesby-Olsen and Mortz, {Charlotte G} and Carsten Bindslev-Jensen",
year = "2019",
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TY - JOUR

T1 - Exercise-induced anaphylaxis

T2 - causes, consequences and management recommendations

AU - Christensen, Morten J

AU - Eller, Esben

AU - Kjaer, Henrik F

AU - Broesby-Olsen, Sigurd

AU - Mortz, Charlotte G

AU - Bindslev-Jensen, Carsten

PY - 2019/3

Y1 - 2019/3

N2 - INTRODUCTION: Exercise induced anaphylaxis (EIA) denotes a range of disorders where anaphylaxis occurs in relation to physical exercise. Typical symptoms include flushing, pruritus, urticaria, angioedema, respiratory symptoms, gastro-intestinal symptoms, hypotension, and collapse during or after exercise. The far best described entity within EIA is food-dependent exercise-induced anaphylaxis (FDEIA), where symptoms only occur in combination with food intake. Frequency and predictability of symptoms vary, and some patients experience symptoms only if exercise is accompanied by other co-factors Areas covered: In the present review, we aimed to provide an overview of EIA, diagnostic workup, causes, management and discuss areas in need of further research. Expert opinion: Though rare, EIA is an entity that all allergists and practicing physicians should recognize. The pathophysiological and immunological mechanisms of EIA are largely unknown. Management is centered upon avoidance of eliciting factors, where emergency plans are individualized, except a mandatory prescription of an adrenaline auto-injector.

AB - INTRODUCTION: Exercise induced anaphylaxis (EIA) denotes a range of disorders where anaphylaxis occurs in relation to physical exercise. Typical symptoms include flushing, pruritus, urticaria, angioedema, respiratory symptoms, gastro-intestinal symptoms, hypotension, and collapse during or after exercise. The far best described entity within EIA is food-dependent exercise-induced anaphylaxis (FDEIA), where symptoms only occur in combination with food intake. Frequency and predictability of symptoms vary, and some patients experience symptoms only if exercise is accompanied by other co-factors Areas covered: In the present review, we aimed to provide an overview of EIA, diagnostic workup, causes, management and discuss areas in need of further research. Expert opinion: Though rare, EIA is an entity that all allergists and practicing physicians should recognize. The pathophysiological and immunological mechanisms of EIA are largely unknown. Management is centered upon avoidance of eliciting factors, where emergency plans are individualized, except a mandatory prescription of an adrenaline auto-injector.

KW - Anaphylaxis

KW - FDEIA

KW - augmentation

KW - co-factors

KW - diagnosis

KW - exercise

KW - exercise induced anaphylaxis

KW - food allergy

KW - food dependent exercise induced anaphylaxis

KW - management

U2 - 10.1080/1744666X.2019.1562904

DO - 10.1080/1744666X.2019.1562904

M3 - Review

C2 - 30601082

VL - 15

SP - 265

EP - 273

JO - Expert Review of Clinical Immunology

JF - Expert Review of Clinical Immunology

SN - 1744-666X

IS - 3

ER -