Porcel S, Sánchez A B, Rodríguez E, Fletes C, Alvarado M, Jiménez S, Hernández J
Allergy Department, Complejo Hospitalario de Cáceres, Cáceres, Spain.
J Investig Allergol Clin Immunol. 2006;16(1):71-3.
We report the case of a 16-year-old male who, 30 minutes after beginning to play football with previous ingestion of pistachio nuts, experienced an anaphylactic reaction. Prick-by-prick test with roasted pistachios was negative. Specific IgE antibodies to pistachio, cashew nuts and mango were negative. An open oral challenge test with pistachio in resting conditions was negative. Treadmill ergonometric stress in a fasting state and 60 minutes after a meal without pistachio gave negative results. A specific food exercise challenge 60 minutes after ingestion of 50 g pistachio nuts was positive, showing mild diffuse erythema and small wheals in face and thorax. To the best of our knowledge, this is the first described case of specific food dependent exercise-induced anaphylaxis to pistachio. Negative allergologic tests is an unusual condition, since most cases appear to be IgE-mediated. In this case, a positive specific food exercise challenge test provided a definite diagnosis.
我们报告了一名16岁男性的病例，该男性在之前食用开心果后开始踢足球30分钟后出现过敏反应。对烤开心果进行逐点刺试验结果为阴性。针对开心果、腰果和芒果的特异性IgE抗体均为阴性。在静息状态下对开心果进行开放性口服激发试验结果为阴性。在禁食状态下以及进食不含开心果的食物60分钟后进行跑步机运动耐力测试结果为阴性。在摄入50克开心果60分钟后进行的特定食物运动激发试验结果为阳性，面部和胸部出现轻度弥漫性红斑和小风团。据我们所知，这是首例描述的对开心果发生特异性食物依赖运动诱发过敏反应的病例。过敏测试结果为阴性是一种不寻常的情况，因为大多数病例似乎是由IgE介导的。在该病例中，特定食物运动激发试验结果为阳性提供了明确的诊断。
