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Food-dependent exercise-induced anaphylaxis (FDEIA) suspected triggered by lipid transfer protein in a Chinese child: A case report
Abstract
Lipid transfer protein (LTP) has been documented as the dominant protein involved in food-induced anaphylaxis and food-dependent exercise-induced anaphylaxis (FDEIA) patients from Mediterranean European countries. To date, there is no report of FDEIA triggering by LTP in China. A 12-year-old Chinese boy experienced recurrent anaphylaxis during intense exercise for 3 months. Specific immunoglobulin E was performed using ImmunoCAP (Thermo Fisher Scientific, Sweden) and Euroline (EUROIMMUN, Germany). He was sensitized to several pollens, mainly mugwort (62 KUA/L), and was found to have detectable immunoglobulin E in multiple foods: cereal (wheat, barley, oat maize, rice, buckwheat, and common millet), fruits (peach, apple, grape, cherry, and orange), vegetables (lettuce, cabbage, broccoli, cauliflower, tomato, and celery), and legumes and nuts (soybean, peanut, and walnut). He also showed sensitization to LTP components from mugwort Art v3 (79.7 KUA/L) and wheat Tri a14 (12.4 KUA/L), but negative to gluten, gliadin, and omega-5 gliadin. We advised our patient to carry an epinephrine auto-injector, not to exercise alone, and to avoid wheat and fruit/vegetable ingestion for at least 4 hours before exercise or when taking non-steroidal anti-inflammatory drugs. After a 6-month follow-up, the patient has experienced no episode of anaphylaxis. We reported the first documented FDEIA case suspected triggered by LTP in a Chinese child. Clinicians should be aware of LTP sensitization when anaphylaxis occurs during exercise in individuals with multiple pollen and food sensitization.
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“Unlike other allergen families, LTPs, such as Tri a 14 in wheat, are implicated not only in PFAS but also in wheat-dependent exercise-induced anaphylaxis (WDEIA) [153].”
From Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges (2024) · cites this paper as [153]
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Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges
Haidar, L., Bănărescu, C. F., Uța, C., Moldovan, S. I., Zimbru, E.-L., Zimbru, R.-I., Ciurariu, E., Georgescu, M., & Panaitescu, C. (2024) · Applied Sciences · doi:10.3390/app15010066 · Cited by 21
Metadata
- Authors
- Jiang, N., Guan, K., & Xiang, L.
- Affiliations
- Department of Allergy, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Venue
- Asia Pacific Allergy
- Published
- 2024-08-05
- Volume
- 14
- Issue
- 3
- Pages
- 148-150
- ISSN
- 2233-8276
- 2233-8268
- PMC
- PMC11365675
- Cited by
- 4
- References
- 0
- Language
- en
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- Jiang, N., Guan, K., & Xiang, L. (2024). Food-dependent exercise-induced anaphylaxis (FDEIA) suspected triggered by lipid transfer protein in a Chinese child: A case report. Asia Pacific Allergy. https://doi.org/10.5415/apallergy.0000000000000154
