Background Oral mite anaphylaxis (OMA) is a condition characterized by severe allergic reactions after ingesting food containing dust mite-contaminated flour. Physical exertion is recognized as a common trigger factor inducing anaphylaxis. The association of OMA with exercise-induced anaphylaxis has rarely been reported. Case presentation We report a 29-year-old Thai woman who had dust mite ingestion-associated, exercise-induced anaphylaxis who tolerated the same bag of contaminated flour without exercise. A sample of contaminated cooking flour was examined under a light microscope. Living mites, Dermatophagoides farinae, were detected by a medical entomologist based on the morphology. We performed skin test to both mite-contaminated and newly opened Gogi® cooking flour, common aeroallergens, food allergens, and all other ingredients in the fried coconut rice cake 5 weeks after the anaphylactic episode. Specific IgE tests, using ImmunoCAP were also performed. Conclusions Dust mite ingestion-associated, exercise-induced anaphylaxis may be misdiagnosed as wheat-dependent exercise-induced anaphylaxis and should be suspected in patients with anaphylaxis linked to food intake and exercise, but who have no apparent evidence to the index food ingredients on allergy workup.

中文翻译：

---

尘螨摄入相关，运动诱发的过敏反应：病例报告和文献综述。

背景 口腔螨过敏反应 (OMA) 是一种以摄入含尘螨污染面粉的食物后出现严重过敏反应为特征的病症。体力消耗被认为是诱发过敏反应的常见触发因素。OMA 与运动诱发的过敏反应的关联很少见报道。病例介绍 我们报告了一名 29 岁的泰国女性，她患有与摄入尘螨有关的运动诱发的过敏反应，她在没有运动的情况下耐受了同一袋受污染的面粉。在光学显微镜下检查了一份受污染的烹调面粉样品。医学昆虫学家根据形态检测出活螨虫，即粉尘螨。我们对被螨虫污染的和新开的 Gogi® 烹饪面粉、常见的空气过敏原、食物过敏原、以及过敏发作 5 周后油炸椰子年糕中的所有其他成分。还进行了使用 ImmunoCAP 的特定 IgE 测试。结论 尘螨摄入相关的运动诱发的过敏反应可能被误诊为小麦依赖性运动诱发的过敏反应，应怀疑与食物摄入和运动相关的过敏反应患者，但没有明显证据表明食物成分对过敏的索引检查。