Acute medicine & surgery · 2015
Diagnosis and long-term management of hydrolyzed wheat protein wheat-dependent exercise-induced anaphylaxis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Hirata Jun-Ichi, Ohya Munehiko, Kumon Keiji
Аннотация
CASE: A 37-year-old woman was admitted to the emergency room with bilateral periorbital edema, hypotension, and expiratory stridor that developed 30 min after starting to hang out washing following consumption of a jam bun. Despite no food allergies or similar episodes, she had recently developed facial wheals after bathing.
OUTCOME: She was immediately and repeatedly administered adrenalin and succinic acid hydrocortisone sodium for wheat-dependent exercise-induced anaphylaxis. On the third hospital day, radioallergosorbent testing reactions to wheat, gluten, and omega-5 gliadin were mildly positive; skin-prick tests for hydrolyzed wheat protein and a face-wash challenge were positive. Therefore, we diagnosed hydrolyzed wheat protein wheat-dependent exercise-induced anaphylaxis. Despite advising her about hyposensitization, the episode recurred and an adrenalin auto-injector was prescribed.
CONCLUSION: Differentiating hydrolyzed wheat protein wheat-dependent exercise-induced anaphylaxis from conventional wheat-dependent exercise-induced anaphylaxis is important owing to their severity and similarities. Each requires long-term management of patients' etiological conditions by advising them about hyposensitization and prescribing adrenalin auto-injectors.
OUTCOME: She was immediately and repeatedly administered adrenalin and succinic acid hydrocortisone sodium for wheat-dependent exercise-induced anaphylaxis. On the third hospital day, radioallergosorbent testing reactions to wheat, gluten, and omega-5 gliadin were mildly positive; skin-prick tests for hydrolyzed wheat protein and a face-wash challenge were positive. Therefore, we diagnosed hydrolyzed wheat protein wheat-dependent exercise-induced anaphylaxis. Despite advising her about hyposensitization, the episode recurred and an adrenalin auto-injector was prescribed.
CONCLUSION: Differentiating hydrolyzed wheat protein wheat-dependent exercise-induced anaphylaxis from conventional wheat-dependent exercise-induced anaphylaxis is important owing to their severity and similarities. Each requires long-term management of patients' etiological conditions by advising them about hyposensitization and prescribing adrenalin auto-injectors.