Food-dependent exercise-induced anaphylaxis with negative allergy testing.

Food-dependent exercise-induced anaphylaxis (FDEIA) is a disorder where exercise following allergen ingestion triggers anaphylaxis although exercise and allergen exposure are independently tolerated. The diagnosis of FDEIA is based on a characteristic clinical history. The culprit allergen is usually confirmed through the use of skin prick testing (SPT) serum-specific IgE levels and a food-exercise challenge. We present a case of FDEIA suggested by clinical history and open food-exercise challenge with negative specific IgE levels and SPT that highlights the challenges involved in diagnosing and managing this rare disorder.