Introduction
Cow’s milk (CM) and wheat are the second and third most common causes of
childhood food allergies in Japan, respectively.1Although most children with these allergies acquire tolerance
spontaneously with age, some do not.2–5 While oral
immunotherapy (OIT) for CM or wheat in patients who do not acquire
tolerance has been shown to be effective in
achieving
desensitization,6–9 exercise after ingestion of the
causative antigen can cause immediate allergic symptoms in those
children.10–14 Manabe et al. suggested two types of
exercise-induced allergic symptoms: food-dependent exercise-induced
anaphylaxis (FDEIA or FEIAn)15 and desensitization
status and exercise-induced anaphylaxis.10,16
We have previously reported on 14 cases of exercise-induced allergic
reactions among 20 patients who were desensitized to 5,200 mg wheat
protein after rush OIT (ROIT).11 We designated this
status as “exercise-induced allergic reaction on desensitization”
(EIARD). There are also several case reports of EIARD after both slow
OIT and ROIT.11,12–14 However, there are no case
series or case control studies of EIARD after the implementation of slow
OIT. Therefore, this study aimed to analyze the results of exercise
provocation tests (EPTs) for the diagnosis of EIARD after slow OIT and
identify the factors associated with EIARD.