To describe a case of exercise-induced anaphylaxis presenting with lower lid angioedema.

A 35-year-old female patient for the past 3 years experienced lower lid edema in her left eye after exercising. In the treadmill exercise test, sneezing, coughing, and lower lid edema in her left eye appeared 13 minutes after initiating exercise. Additionally, contrast-enhanced computed tomography scan revealed minimal soft tissue thickening of the left inferior periorbital subcutaneous area with subtle enhancement after exercise. The serum immunoglobulin E (IgE) test showed elevated total IgE levels. The patient was diagnosed with exercise-induced anaphylaxis based on the above results. We informed the patient on her trigger factors and possible symptoms and prescribed an oral antihistamine and steroid.

In patients presenting with facial edema or eyelid edema after exercise, the possibility of exercise-induced anaphylaxis should be considered. In addition, we have to aware of possibility of complication such as airway obstruction or a life-threatening condition, and it is needed to prevent a recurrence of anaphylaxis by cooperating with other department.