Table 1 Exercise induced anaphylaxis: differential diagnoses
Swelling/angio-oedema

  • Chronic urticaria and angioedema

  • ACEI medication intake

  • Complement deficiency/dysfunction

Cutaneous/flushing

  • Cholinergic urticaria

  • EIU, physical urticaria secondary to pressure, vibration, sunlight, sweat

  • Physiological flushing

  • Scromboid fish poisoning

  • Mastocytosis

  • Rare: peptide secreting tumours (Carcinoid, VIPoma). Medullary carcinoma of thyroid, or phaechromocytoma

Neurological

  • Epileptic seizure

  • Vasovagal episodes

Vascular

  • Cardiac abnormalities, e.g. arrhythmias

  • Vasovagal episodes

  • Systemic inflammatory syndromes

Upper airway symptoms

  • Vocal cord dysfunction

  • Panic disorders

Lower airway symptoms

  • Exercise-induced asthma

  • Reproduced and modified from [22] with permission from the publisher.