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Keywords:

  • anaphylaxis;
  • co-factor;
  • exercise;
  • food allergy;
  • nonsteroidal anti-inflammatory drugs

Abstract

Background

Alcohol, exercise or non-steroidal anti-inflamatory drugs (NSAID) are frequently mentioned as amplifiers of food allergic reactions but only individual cases or small series have been previously published.

Methods

Descriptive study including 74 cases of suspected co-factor enhanced food allergy, assessed by skin-prick tests, specific IgE and oral challenges.

Results

Anaphylaxis accounted for 85.1% of reactions. In 99% of cases culprit food allergens were plant-derived, mainly vegetables and cereals. NSAID were involved in 58%, exercise in 52.7% and alcohol in 12.2%. Lipid transfer protein was the most frequently involved allergen.

Conclusions

Co-factor enhanced food allergy should be considered when assessing food, alcohol, exercise and NSAID allergic reactions.