Allergy Unit, Pediatrics Section, Department of Woman and Child Health, Policlinico Gemelli Universitary Foundation IRCCS, Catholic University of Sacre Hearth, Rome 00168, Italy..
Acta Biomed. 2020 Dec 22;92(1):e2021068. doi: 10.23750/abm.v92i1.10093.
Food-dependent exercise-induced anaphylaxis (FDEIA) is an IgE-mediated allergy resulting from the combination of the ingestion of an offending food and physical exercise. According literature, oral food challenge (OFC) followed by physical exercise (OFCPE) should be considered the diagnostic gold standard. In the absence of adverse reactions, other cofactors should be added (e.g. acetylsalicylic acid, alcohol in adulthood), one at a time. But many other factors increase patient's reactivity. This could reduce the sensitivity of the OFCPE and, consequently, make instructions for patients less reliable. On the other hand, the addition of cofactors not reported by the patient may reduce test specificity. With the help of two exemplary stories, that present opposite outcomes, diagnostic difficulties of FDEIA are discussed.
食物依赖运动诱发的过敏反应（FDEIA）是一种 IgE 介导的过敏反应，由摄入致敏食物和体力活动共同作用引起。根据文献记载，口服食物激发试验（OFC）后进行体力活动（OFCPE）应被视为诊断的金标准。在没有不良反应的情况下，应逐个添加其他诱发因素（例如乙酰水杨酸、成年后饮酒）。但是，许多其他因素会增加患者的反应性。这可能会降低 OFCPE 的敏感性，从而使对患者的指导不太可靠。另一方面，添加患者未报告的诱发因素可能会降低测试的特异性。通过两个相反结果的示例故事，讨论了 FDEIA 的诊断难点。
