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Exercise-induced anaphylaxis

Anaphylaxis which occurs after prolonged strenuous exercise often in conditionned runners. Exercise-induced anaphylaxis (EIA) was defined for the first time in 1980. EIA is associated with different kind of exercise, although jogging is the most frequently reported. Symptoms usually begin about 30 minutes after exercise is started and last from one half to four hours.

The clinical manifestations progress from itching, erythema and urticaria to some combination of cutaneous angioedema, gastrointestinal and laryngeal symptoms and signs of angioedema and vascular collapse. It is usually preceded by a short prodrome of generalized warmth and pruritus.. Urticaria and angioedema of the face, palms, and soles develop, together with upper respiratory truct obstruction and a choking sensation. Occasionally, these manifestations are accompanied by vascular collapse, hypotension, and bradycardia or tachycardia [1].Mast cell participation in the pathogenesis of this syndrome has been proved by the finding of an elevated serum histamine level during experimentally-induced attacks and by cutaneous degranulation of mast cells with elevated serum tryptase after attacks [2]..

As predisposing factors of EIA, a specific or even aspecific sensitivity to food has been reported and such cases are called "food-dependent EIA". Many foods are implicated but particularly wheat, vegetables, crustacean. Another precipitating factor includes drugs intake (non steroidal anti-inflammatory drugs), climate variations and menstrual cycle factors. Treatment of an attack should include all the manoeuvres efficacious in the management of conventional anaphylactic syndrome, including the administration of epinephrine and antihistamines. Prevention of the attacks may be achieved with the interruption of the exercise at the appearance of the first premonitory symptoms. To prevent the onset of EIA it is also suitable to delay the exercise practice after at least 4-6 hours from the swallowing of food [2].


1. Levy, J.H., et al: Anaphylactic and anaphylactoid reactions: A review spine 1986:11(3):282-91.

2. Gani F, Selvaggi L, Roagna D. Exercise-induced anaphylaxis.Recenti Prog Med. 2008 Jul-Aug;99(7-8):395-400.

Γκέλης Ν.Δ. - Λεξικό Αλλεργίας - Εκδόσεις ΒΕΛΛΕΡOΦΟΝΤΗΣ - Κόρινθος 2013

Gelis Ν.D. - Dictionary of Allergies - VELLEROFONTIS Publications - Corinth 2013