Co-factor-enhanced Food Allergy
Alcohol, exercise or non-steroidal anti-inflamatory drugs (NSAID) are frequently mentioned as amplifiers of food allergic reactions but only individual cases or small series have been previously published. A descriptive study including 74 cases of suspected co-factor enhanced food allergy, assessed by skin-prick tests, specific IgE and oral challenges, reports that anaphylaxis accounted for 85.1% of reactions. In 99% of cases culprit food allergens were plant-derived, mainly vegetables and cereals. NSAID were involved in 58%, exercise in 52.7% and alcohol in 12.2%. Lipid transfer protein was the most frequently involved allergen. The study concludes that co-factor enhanced food allergy should be considered when assessing food, alcohol, exercise and NSAID allergic reactions.
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Cardona V, Luengo O, Garriga T, Labrador-Horrillo M, Sala-Cunill A, Izquierdo A, Soto L, Guilarte M. Co-factor-enhanced food allergy . Allergy. 2012 Oct;67(10):1316-8. 2012 Jul 30 epub. http://www.ncbi.nlm.nih.gov/pubmed/22845005