Exercise-Induced Anaphylaxis in an Air Force Aviator Taking a HMG-CoA Reductase Inhibitor: A Case Report and Review of the Presentation, Diagnoses, and Treatment

ABSTRACT Background: A 46-year-old healthy male Air Force pilot presented to the emergency department (ED) experiencing symptoms of exercise-induced anaphylaxis (EIAn), during a vigorous outdoor run. The patient recovered in the ED and was seen, subsequently, by a civilian allergist; eventually a diagnosis consistent with EIAn was made. EIAn is a rare but potentially life-threatening syndrome believed to involve IgE mediated release of histamine and other immunoactive compounds, during or after exercise. The diagnosis is determined by a strong clinical suspicion along with careful exclusion of other potential diagnoses. Interestingly, this particular patient was also found to have a possible correlation between the introduction of 3-hydroxy-3-methylglutaryl-coenzyme A, for hyperlipidemia, shortly before his first episode of EIAn, and remission of the condition since discontinuing the statin medication. Methods: A detailed review of the clinical notes, ED presentation, and all subspecialty consultation not...