ABSTRACT
The human anaphylactic response results from the activation of a variety of potent mediator systems, involving both immunoglobulin E– (IgE) and non-IgE-dependent pathways, and manifests as an immediate systemic response to a variety of stimuli. Exercise-induced anaphylaxis (EIA) is a syndrome in which symptoms similar to those of anaphylactic reaction to foreign substance occur, but in association with exercise. An interesting and unique feature of EIA is the relationship of this entity to antecedent ingestion of specific foods. The sequence of biochemical events, mediator release, and cellular and neurohumoral pathways in the development of EIA is unknown. Cardiac syndromes resulting from exercise cause angina, syncope, arrhythmias, palpitations, and even features of left ventricular failure but not pruritus, urticaria, angioedema, true airway obstruction, or gastrointestinal colic. Cholinergic urticaria needs to be differentiated from EIA as they both represent physical allergies, are temporally related to exercise, and have cutaneous manifestation.
