Le Bon Chami Beatrice, Charif Fida, El Zoghbi Silvana, Challita Samir, Zaitoun Fares
Pulmonology and Critical Care, Notre Dame Maritime Hospital, Jbeil, LBN.
Vascular and Therapeutic Medicine, Centre Hospitalier Universitaire de Saint Etienne, Saint-Etienne, FRA.
Cureus. 2025 Mar 31;17(3):e81529. doi: 10.7759/cureus.81529. eCollection 2025 Mar.
Anaphylaxis, a potentially life-threatening systemic reaction, is an increasingly common reason for emergency department (ED) admissions, which often poses diagnostic challenges. We present a case of a 62-year-old man who had recurrent anaphylaxis, initially suspected to be triggered by non-steroidal anti-inflammatory drugs (NSAIDs). By conducting thorough history-taking and comprehensive allergy testing, we identified allergic sensitization to the omega-5-gliadin (O5G) component of gluten, which manifested only when wheat consumption was accompanied by specific factors, notably exercise or NSAID use. He was diagnosed eight years after the first anaphylactic episode with wheat-dependent exercise-induced anaphylaxis (WDEIA). Adherence to a gluten-free diet effectively prevented further episodes. This case underscores the importance of emergency physicians not only in treating anaphylaxis but also in recognizing rare diagnoses, such as cofactor-enhanced food-induced allergic reactions, and understanding their management. This awareness is critical not only for conducting comprehensive assessments in collaboration with allergy specialists but also for facilitating earlier diagnosis, educating patients about the use of epinephrine auto-injectors, and emphasizing essential avoidance measures to prevent the recurrence of anaphylaxis.
过敏反应是一种潜在的危及生命的全身性反应，是急诊科（ED）收治患者越来越常见的原因，这常常带来诊断挑战。我们报告一例62岁男性复发性过敏反应病例，最初怀疑由非甾体抗炎药（NSAIDs）引发。通过详细询问病史和全面的过敏测试，我们确定患者对麸质的ω-5-麦醇溶蛋白（O5G）成分过敏，这种过敏仅在食用小麦并伴有特定因素时出现，特别是运动或使用NSAIDs。在首次过敏反应发作八年后，他被诊断为小麦依赖运动诱发的过敏反应（WDEIA）。坚持无麸质饮食有效地预防了进一步发作。该病例强调了急诊医生不仅在治疗过敏反应方面的重要性，而且在识别罕见诊断（如辅因子增强的食物诱发过敏反应）以及了解其管理方面的重要性。这种认识不仅对于与过敏专科医生合作进行全面评估至关重要，而且对于促进早期诊断、教育患者使用肾上腺素自动注射器以及强调预防过敏反应复发的基本避免措施也至关重要。
