A case of food-dependent exercise-induced anaphylaxis caused by various foods which contained flour for thirty years]

The patient was a 65-year-old man with chief complaints of flare, swelling, itching and loss of consciousness. He had a history of diabetes diagnosed at the age of 34 years and was receiving medication from a local doctor. He had experienced systemic flare, swelling and loss of consciousness 20 minutes after drinking beer at a party at the age of 34 years. Since that time, he had frequently experienced urticaria and loss of consciousness while taking a walk after eating various foods (all of which contained flour). In February 2001, he experienced systemic flare, swelling and loss of consciousness when he returned home from a walk after eating a meal that included meat dumplings. Laboratory tests on admission showed a serum IgE level of 253 IU/ml, and the IgE level for flour in a RAST was 2.13 UA/ml (class 2). The results of exercise tolerance tests were normal during fasting, after ingestion of food that did not include allergens (wheat, shrimps and crab) and after ingestion of half of a thick slice of white bread, but systemic wheal and flare reactions appeared during an exercise tolerance test after ingestion of one thick slice of white bread. A diagnosis of food-dependent exercise-induced anaphylaxis caused by flour was made on the basis of the results.