Korean J Asthma Allergy Clin Immunol.  2011 Jun;31(2):153-156.

A Case of Exercise-induced Asthma Associated with Cholinergic Urticaria in a Patient with Allergic Rhinitis

Abstract

Exercise-induced asthma that presents with typical symptoms, such as shortness of breath, chest tightness and cough, occurs after exercise. Cholinergic urticaria occurs due to the conditions that increase core body temperature, such as exercise, hot bath, sauna or emotional stress. A 21-year-old male experienced wheezing, dyspnea and urticaria on his whole body after exercise at the age of 12. Thereafter, he experienced pinpoint-sized urticaria after exercise, sauna or emotional stress as well as during outdoor activities in summer. Wheezing and dyspnea sometimes appeared without any skin rashes after light exercise, while skin rashes occurred only after sauna. The result of treadmill exercise test was positive: FEV1 decreased by 36% relative to that of the baseline value and pinpoint-sized urticaria appeared on his trunk, back and face. Intradermal injection of 0.1 mL of methacholine (0.01 mg/mL) produced hives. Based on these results, we confirmed that cholinergic urticaria was accompanied by exercise-induced asthma in this patient.

MeSH Terms

Asthma, Exercise-Induced
Baths
Body Temperature
Cough
Dyspnea
Exanthema
Exercise Test
Humans
Injections, Intradermal
Light
Male
Methacholine Chloride
Respiratory Sounds
Rhinitis
Rhinitis, Allergic, Perennial
Steam Bath
Stress, Psychological
Thorax
Urticaria
Young Adult
Methacholine Chloride