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

Pediatr Allergy Immunol Pulmonol. 2022 Dec;35(4):166-169. doi: 10.1089/ped.2022.0122. Epub 2022 Nov 23.

Abstract

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.

Keywords: anaphylaxis; antigen analysis; carrot; food allergy; food-dependent exercise-induced anaphylaxis (FDEIA).

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allergens
  • Anaphylaxis* / diagnosis
  • Anaphylaxis* / etiology
  • Child
  • Daucus carota*
  • Exercise
  • Exercise-Induced Allergies*
  • Food Hypersensitivity* / complications
  • Food Hypersensitivity* / diagnosis
  • Humans
  • Male

Substances

  • Allergens