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Food-Dependent Exercise-Induced Anaphylaxis Caused by Carrots: A Case Report.

Nami HiraiMika OgataJun KidoMasashi NakamuraNayu SatoNobue TakamatsuNaoshi ShimojoYuji AokiKayoko MatsunagaTomoyuki Mizukami
Published in: Pediatric allergy, immunology, and pulmonology (2022)
Background: Most cases of food-dependent exercise-induced anaphylaxis (FDEIA) are caused by eating wheat or crustaceans. However, fruits or vegetables may rarely act as allergens for FDEIA. We report a rare case of FDEIA caused by eating carrots. Case Presentation: An 8-year-old boy developed an anaphylactic reaction while playing, after eating lunch that included cooked carrots. Serum carrot-specific immunoglobulin E level was 0.19 UA/mL. The prick-by-prick test for raw carrots was positive ( wheal diameter: 4 mm ) . The patient developed urticaria after exercise provocation tests following ingestion of raw carrots. Carrot proteins were analyzed by 2-dimensional Western blotting to identify the causative allergens. Nine proteins were identified as candidate antigens at 21-66 kDa. Conclusions: Our patient presented with FDEIA symptoms after ingesting both raw and cooked carrots. Both raw and cooked carrots contain 9 proteins that may induce FDEIA.
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