A cautionary tale for the physician: case report and review of food-dependent exercise-induced anaphylaxis

Food-dependent exercise-induced anaphylaxis (FDEIA) is a rare subset of anaphylaxis that only occurs when a patient consumes the causative food (or in some cases non-specific food intake) within four to six hours prior to physical exercise. It may be triggered by a variety of foods, but most commonly wheat, shellfish, and peanuts, and is treated similarly to general anaphylaxis [1,2]. Though various case reports have described this phenomenon, FDEIA is rare and thought to be underdiagnosed as lack of familiarity with the condition likely results in many practitioners failing to include FDEIA in their differential diagnosis of patients presenting with anaphylaxis. With the publication of this case, we hope to raise awareness of physicians who may encounter such patients during exercise or athletic activities.