Food-dependent exercise-induced anaphylaxis due to ingestion of orange.

Sir, Food-dependent exercise-induced anaphylaxis (FDEIA) is an unusual clinical syndrome of immediate allergic reaction that requires both ingestion of an allergenic food and exercise to induce anaphylaxis (1). Since the first occurrence as a result of exercise and the ingestion of shellfish was published in 1979 (2), foods such as shrimp, shellfish, wheat, celery, tomato, nuts and fruits (including grapes and apples) have been reported in relation to FDEIA (1 – 5). However, citrus fruit such as orange has never been reported as a cause of FDEIA, although it is widely eaten throughout the world. We report the first case of exercise-induced anaphylaxis in association with ingestion of orange.