| Abstract [eng] |
Aim. Systematically review the scientific literature on the etiology, clinical features, diagnostic methods, and management of Food-Dependent Exercise-Induced Anaphylaxis, and describe a clinical case of Wheat-Dependent Exercise-Induced Anaphylaxis. Methods. The scientific literature was conducted using the international database PubMed and specialized information retrieval system Google Scholar. Filters and keywords: “Food-Dependent Exercise-Induced Anaphylaxis“, “Wheat-Dependent Exercise-Induced Anaphylaxis“, “epidemiology“, “diagnosis“, “management“, were applied to optimize source selection. During the initial screening, titles and abstracts were reviewed, duplicated or irrelevant articles were excluded. A total of 79 articles published in English from 2015-2026 were selected, preference given to those published within the last five years that provided comprehensive information on epidemiology, etiology, diagnosis and management on Food-Dependent Exercise-Induced Anaphylaxis. Data storage was performed with Zotero management software. Case report. In 2020, a 36-year-old woman began to experience recurrent urticaria rash. Since 2021, the rashes have progressed, episodes became more intense and recurred more frequently. During urticaria episodes, the patient suffered not only from wheals all over her body, but also started to experience systemic symptoms, such as pronounced lower abdomen spasms, severe dizziness, and during severe exacerbations, transient and recurrent episodes of loss of consciousness. In August 2023, the patient experienced several episodes, the onset of which was clearly associated with physical activity. The patient was consulted by several allergologists and in the absence of significant changes in the laboratory tests, she was diagnosed with chronic spontaneous urticaria. In November 2023, an ALEX2 molecular test was performed, confirming sensitization to omega-5-gliadin, a wheat protein that can cause hypersensitivity reactions associated with wheat consumption and physical activity. For management of wheals and pruritus, antihistamines were prescribed. Due to the high risk of recurrent anaphylaxis, the patient was advised to always carry an automatic epinephrine injector, she was also advised to avoid physical activities, nonsteroidal anti-inflammatory drugs, alcohol consumption in combination with wheat. Conclusions. Food-related exercise-induced anaphylaxis is a rare but potentially life -threatening hypersensitivity allergic reaction characterized by challenging, often delayed diagnosis due to the variability of clinical symptoms, incompletely understood pathogenesis, and lack of standardized diagnostic protocols. The most effective way to manage the condition is to strictly avoid triggering foods and/or exercise for at least 4–6 hours after eating. Adrenaline is the first-line treatment for anaphylaxis, while antihistamines are used to control skin symptoms. The presented clinical case highlights the diagnostic challenge of food-dependent exercise-induced anaphylaxis, the importance of differential diagnosis, and the need for further research focused on the development of standardized diagnostic and treatment strategies. |
