J Korean Ophthalmol Soc.  2015 Sep;56(9):1459-1463. 10.3341/jkos.2015.56.9.1459.

A Case of Exercise-Induced Anaphylaxis Presenting with Lower Lid Angioedema

• You JR
• Kim MH
• Sung YM
• Yang SW

• KMID: 2214564
• DOI: http://doi.org/10.3341/jkos.2015.56.9.1459

Abstract

PURPOSE
To describe a case of exercise-induced anaphylaxis presenting with lower lid angioedema.
CASE SUMMARY
A 35-year-old female patient for the past 3 years experienced lower lid edema in her left eye after exercising. In the treadmill exercise test, sneezing, coughing, and lower lid edema in her left eye appeared 13 minutes after initiating exercise. Additionally, contrast-enhanced computed tomography scan revealed minimal soft tissue thickening of the left inferior periorbital subcutaneous area with subtle enhancement after exercise. The serum immunoglobulin E (IgE) test showed elevated total IgE levels. The patient was diagnosed with exercise-induced anaphylaxis based on the above results. We informed the patient on her trigger factors and possible symptoms and prescribed an oral antihistamine and steroid.
CONCLUSIONS
In patients presenting with facial edema or eyelid edema after exercise, the possibility of exercise-induced anaphylaxis should be considered. In addition, we have to aware of possibility of complication such as airway obstruction or a life-threatening condition, and it is needed to prevent a recurrence of anaphylaxis by cooperating with other department.

Keyword

Angioedema; Exercise-induced anaphylaxis

MeSH Terms

Adult
Airway Obstruction
Anaphylaxis*
Angioedema*
Cough
Edema
Exercise Test
Eyelids
Female
Humans
Immunoglobulin E
Immunoglobulins
Recurrence
Sneezing
Immunoglobulin E
Immunoglobulins

Figure

• 

  Figure 1 . Clinical photograph. (A) Clinical photograph at resting state. (B) Clinical photograph after exercise. Lowe lid edema in left eye (arrow).

• 

  Figure 2. Computed tomography (CT) image. (A) Axial enhnaced CT scan reveals no significant abnormal lesion in the both lower lid area at resting state. (B) Axial enhanced CT scan reveals minimal soft tissue thickening of left inferior periorbital subcutaneous area with subtle enhancement (arrow) after exercise.

Reference

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