BMJ Case Reports 2018; doi:10.1136/bcr-2017-222370
  • Unusual presentation of more common disease/injury

Food-dependent exercise-induced anaphylaxis

  1. Evelyn M Lomasney2
  1. 1Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
  2. 2Allergy/ Immunology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
  1. Correspondence to Dr Robert H Wauters,{at}
  • Accepted 21 March 2018
  • Published 11 April 2018


Food-dependent exercise-induced anaphylaxis (FDEIAn), first reported in 1979, is a condition defined by the consumption of a trigger food with temporally related exercise that results in an immediate hypersensitivity (type 1) reaction in the setting of the trigger food being tolerated independent of exercise and exercise being tolerated in the absence of trigger food consumption. The most common trigger food in the west is wheat and shellfish in Asia. The exact mechanism of FDEIAn is unknown, though several hypotheses exist. Cofactors such as non-steroidal anti-inflammatory drug use, alcohol consumption and others have been associated with reported cases.


  • Contributors RHW, TAB and EML participated in the drafting and critical revision of the manuscript. All authors approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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