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Exercise-induced anaphylaxis: Clinical manifestations, epidemiology, pathogenesis, and diagnosis

Anna M Feldweg, MD
Section Editor
John M Kelso, MD
Deputy Editor
Elizabeth TePas, MD, MS


Exercise-induced anaphylaxis (EIAn) is a disorder in which anaphylaxis occurs in association with physical exertion. The clinical manifestations, theories of pathogenesis, evaluation, and diagnosis of EIAn and food-dependent, exercise-induced anaphylaxis (FDEIAn) will be reviewed here. The management and prognosis of EIAn and FDEIAn are discussed elsewhere. (See "Exercise-induced anaphylaxis: Management and prognosis" and "Food-induced anaphylaxis".)


Anaphylaxis, from any cause, is defined as a serious allergic or hypersensitivity reaction that is rapid in onset and may cause death [1,2]. The diagnostic criteria for anaphylaxis are reviewed in detail separately. (See "Anaphylaxis: Acute diagnosis", section on 'Diagnostic criteria'.)

The following terms are used in this topic review:

Exercise-induced anaphylaxis (EIAn) – EIAn is a disorder in which anaphylaxis occurs only in association with physical exertion.

Food-dependent, exercise-induced anaphylaxis (FDEIAn) – FDEIAn is a disorder in which symptoms develop only if exercise takes place within a few hours of eating and, in most cases, only if a specific food to which the patient is sensitized is eaten in the pre-exercise period. This definition has been used for several decades, although work in the pathophysiology of FDEIAn has raised the question of whether exercise is absolutely necessary for the development of symptoms. (See 'Theories of pathogenesis' below.)

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Literature review current through: Nov 2017. | This topic last updated: Jul 14, 2017.
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