Bibliographic record
Abstract
Exercise-induced anaphylaxis is a rare disorder characterized by the development of a severe allergic response occurring after mild- to-strenuous physical activity. Food-dependent exercise-induced anaphylaxis (FDEIA) comprises 30-50% of all cases of exercise-induced anaphylaxis [ 2 ]. Diagnosis involves careful history and appropriate skin prick testing and food specific IgE levels [ 4 , 6 ]. However, food dependent exercise challenges may be required to confirm the diagnosis [ 6 ]. We describe the case of a 51 year old male, diagnosed with corn dependent exercise anaphylaxis via serial exercise challenges. Case report and literature review. A 51 year old male military pilot described the following symptoms 10 minutes after running on the treadmill: sudden onset palm pruritus, bilateral arm tingling, urticarial rash on his arms and chest, tongue and eyelid swelling, and difficulty speaking/swallowing. He denied wheezing, shortness of breath, gastrointestinal symptoms, or light-headedness. He was self-treated with 50 mg of diphenhydramine and loratadine. His symptoms resolved in 2-3 hours. He had consumed a Shepherd’s Pie approximately 45 minutes prior to exercise. The ingredients included beef, potato, corn, wheat, flour, and Worchestershire sauce. He denied ingestion of ASA/NSAIDS or alcoholic beverages prior to the event. His past medical history was remarkable for hypercholesterolemia and diet-controlled Diabetes Mellitus. He had a history of seasonal allergies for which he was on maintenance allergen immunotherapy. His medications included Crestor, Coenzyme Q10, and a fiber supplement. Physical examination was unremarkable. Skin prick testing to the individual ingredients of the Shepherd’s Pie were negative. IgE levels were positive for corn and wheat, and negative to the other ingredients. Patient was advised a wheat and corn free diet and was able to resume his exercise routine. Subsequently, he underwent serial food dependent exercise challenges. The exercise challenges verified that corn was the culprit food. The patient was advised to stop eating corn, introduce wheat, and resume his regular exercise routine. He had two minor episodes of urticaria with exertion in the following year, confirmed to be from accidental exposure to corn. This case demonstrated that, although wheat is one of the most common triggers of food dependent exercise induced anaphylaxis, corn was the culprit for this patient’s exercise induced symptoms. Food dependent exercise challenges can be time consuming and associated with risks, but yet important to verify the diagnosis when multiple triggers are suspected.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".