Although exercise-induced anaphylaxis and idiopathic anaphylaxis are not understood as fully as other forms of anaphylaxis, you can find information here about the symptoms and treatments associated with each.

 
Exercise-Induced Anaphylaxis

Exercise-induced anaphylaxis is a form of physical allergy. Although the mechanism by which this reaction occurs has yet to be elucidated, it has been found that some medications (such as aspirin or NSAIDS) or food before exercise increase the probability of experiencing exercise-induced anaphylaxis.¹

Individuals at risk for experiencing exercise-induced anaphylaxis are those with a history of personal or family atopy.¹

Atopy is the increased tendency seen in some individuals to produce IgE antibodies to innocuous substances.

Initial symptoms of exercise-induced anaphylaxis include¹:

• Fatigue
• Diffuse warmth
• Pruritus
• Erythema
• Urticaria

Later onset symptoms of exercise-induced anaphylaxis include:

• Gastrointestinal symptoms
• Laryngeal edema
• Vascular collapse

Treating an emergency case of exercise-induced anaphylaxis is the same as treating other forms of anaphylaxis with the main therapy being epinephrine.¹ Individuals at risk of experiencing exercise-induced anaphylaxis should be advised to carry self-injectable epinephrine, such as the EpiPen^® epinephrine auto-injector and to avoid exercise 4 to 6 hours after eating.¹

Prophylactic medications have not been shown to be useful for exercise-induced anaphylaxis.¹

 
Idiopathic Anaphylaxis

By definition idiopathic anaphylaxis is anaphylaxis caused by an unknown trigger. However, the physician should make a careful analysis of the events and conditions surrounding the attack so as to discover any possible allergens that have previously been unknown.¹

The main symptoms of idiopathic anaphylaxis are the same as for other forms of anaphylaxis and include¹:

• Hives
• Swelling of the throat, lips, tongue, or around the eyes
• Difficulty breathing or swallowing

Other common symptoms of anaphylaxis are:

• Metallic taste or itching in the mouth
• Generalized flushing, itching, or redness of the skin
• Abdominal cramps, nausea, vomiting, or diarrhea
• Tachycardia
• Plunging blood pressure (and accompanying paleness)
• Sudden feeling of weakness
• Anxiety or an overwhelming sense of doom
• Collapse
• Loss of consciousness

Treating an emergency case of idiopathic anaphylaxis is the same as treating other forms of anaphylaxis with the main therapy being epinephrine.¹ Individuals who experience idiopathic anaphylaxis should be treated with epinephrine and advised to carry self-injectable epinephrine, such as EpiPen^®, in the future. Side effects of epinephrine may include palpitations, tachycardia (an abnormally fast heartbeat), sweating, nausea and vomiting, and respiratory difficulty. Cardiac arrhythmias may follow administration of epinephrine. Patients should ask their physician about the circumstances under which this life-saving medication should be used.

Individuals who experience idiopathic anaphylaxis may be treated prophylactically with corticosteroids, beta-agonists, and/or antihistamines, but these therapies require individualization.¹

 
Reference

1. Joint Task Force on Practice Parameters, American Academy of Allergy, Asthma and Immunology, American College of Allergy, Asthma & Immunology, and the Joint Council of Allergy, Asthma and Immunology. The diagnosis and management of anaphylaxis. J Allergy Clin Immunol. 1998;101(6 pt 2):S465-S528.