KENNETH P. MATHEWS, M.D., F.A.C.P.; PAULINE M. PAN, A.B.
A 22-year-old college student with a history of bronchial asthma and allergic rhinitis since early childhood developed cold urticaria at 10 years of age. At age 18 he began to have wheezing and pruritis after exertion, with the appearance of wheals where he scratched himself. There was no mastocytosis or cholinergic urticaria, but he had elevated plasma histamine levels and transient dermographia after strenuous exertion. Similar findings after exercise were not obtained in control young men in the following categories: six normal, nonatopic persons; nine asthmatics; two persons with cold urticaria; and one dermographic subject. The patient showed elevated plasma histamine after immersing one forearm in ice water for 5 min; 10 control subjects did not show this response. The patient's cold allergy, but not the transient dermographia, was passively transferrable. Several studies failed to determine whether physiologic or immunologic abnormalities caused the massive exercise-induced histamine release associated with dermographia and wheezing.
MATHEWS KP, PAN PM. Postexercise Hyperhistaminemia, Dermographia, and Wheezing. Ann Intern Med. ;72:241–249. doi: 10.7326/0003-4819-72-2-241
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Published: Ann Intern Med. 1970;72(2):241-249.
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