Abstract

Exercise induced anaphylaxis (EIA) and exercise-induced rhinitis are both relatively new syndromes. EIA is associated with a different kind of exercise, although jogging is most frequently reported. Clinical manifestations progress from pruritus, erythema and urticaria to some combination of cutaneous angioedema, gastrointestinal and laryngeal symptoms and signs of angioedema and vascular collapse. Mast cell participation in the pathogenesis of this disease has been proved by an elevated serum histamine level during experimentally-induced attenuated attacks and by cutaneous degranulation of mast cells after attacks. As predisponsing factors of EIA, a sensitivity to some specific food or food intake itself has been reported. Treatment of an attack should include those maneuvers efficacious in management of conventional anaphylactic syndromes, including administration of epinephrine. EIR is the least well characterized of the exercise-induced allergic syndromes. In allergic and asthmatic patients a greater increase of total nasal resistance has been reported after exercise in comparison with control subjects. Nasal congestion and rhinorrhea are quite common (90) in skiers, who exercise in cold air. Nasal challenges with cold air in these subjects have been shown to result in release of inflammatory mediators associated with mast cells. Antihistamines are reported to be ineffective in EIR, whilst pretreatment with atropine sulfate in saline nasal spray can effectively block EIR with minimal short-term side effects. Verf.-Referat