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Food-Dependent, Exercise-Induced Anaphylaxis

M. R. El-Dieb, MD
JAMA. 1984;251(24):3224. doi:10.1001/jama.1984.03340480018014.
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To the Editor.—  I would like to comment on the CASE REPORT, "Food-Dependent, Exercise-Induced Anaphylaxis," by Buchbinder et al1 published in a recent issue of The Journal. The episode of exercise-induced anaphylaxis reported by the patient-subject of this article on Aug 22,1982, after eating grapes and jogging for 2 1/2 miles was assumed by the authors to be related somehow to ingestion of the grapes despite the negative results of skin test to the fruit. At the same time, the patient gave a history of seasonal rhinitis and asthma while the skin testing performed by the authors revealed positive flare and wheal reactions to a variety of pollens. In my opinion it is more likely that this episode is an example of an inhalant-provoked anaphylaxis than a food-induced one. The most likely inhalant in this case is ragweed pollen, which is known to be abundant during that time of


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