(Disclaimer: This article is for scientific purposes only, in order to protect the privacy of patients, the relevant information in the following content has been processed) Abstract: Metamorphic reaction is the daily allergic reaction. When people with allergies are exposed to allergic factors, they may have sudden allergic reactions such as itchy eyes, tearing, itchy flushing of the skin all over the body, sneezing, and even tightening of the throat, difficulty in breathing, blurred consciousness, and fainting. In this case, the patient had a severe allergic reaction after consuming wheat products, which led to anaphylactic shock. At the first time, she used epinephrine to get rid of the allergic environment, and after consulting the doctor to identify the allergens, the symptoms were relieved after specific immunotherapy. Basic information] Female, 33 years old [Disease type] Anaphylaxis [Hospital] Zhongnan Hospital of Wuhan University [Consultation time] April 2020 [Treatment plan] Allergen detection, allergen avoidance, epinephrine pen, allergen specific immunotherapy (dust mite, Artemisia absinthium, Humulus lupulus) [Treatment cycle] 2 years, every six months, allergen re-examination [Effect of the treatment] The patient did not suffer from severe allergic reactions and anaphylaxis again. Allergic reaction and anaphylaxis, allergic rhinitis, urticaria symptoms significantly relieved I. Initial face-to-face consultation Patient Xiaomei was going to the toilet at 9:00 a.m. on November 12, 2018, when she had a sudden onset of weakness of the legs, panic attacks, itchy nose, itchy scalp, itchy flushing of the skin all over the body, sneezing, runny nose, the patient stopped exercising, the symptom was not relieved after taking cetirizine orally, and the itchiness on the palms of the hands was intolerable after about 3-5 minutes of further occurrence, After about 3-5 minutes, there was further itching of palms, tightness of throat, chest tightness, and then fainting and collapsing, and his family called 120 to send him to the emergency room. In addition to allergic rhinitis, urticaria, and itchy skin tinea cruris, he did not have any other underlying diseases, and was considered to be allergy-induced anaphylactic shock. At that time, epinephrine was then administered intramuscularly and the symptoms gradually subsided. The above situation occurred five times from 2018 to 2020, and except for one that resolved on its own, all four times were treated by calling 120 emergency room. To further clarify the cause of treatment, the patient visited our outpatient clinic and underwent allergen skin test, serum-specific IgE test, and allergen patch test. The results showed that the patient’s skin test and serum sIgE were positive for dust mite, Artemisia absinthium, Humulus japonicus, and wheat, with a total IgE of 1400 KU/l. Taking into account the patient’s medical history and the fact that every time he had an anaphylactic reaction it was to wheat products, the diagnosis of wheat-dependent exercise-induced severe allergic reaction and anaphylactic shock was established. As the patient had a history of allergic rhinitis and chronic urticaria, he was considered to be allergic to dust mite, Artemisia absinthium and Humulus lupulus, and was advised to undergo specific immunotherapy for dust mite, Artemisia absinthium and Humulus lupulus, which is a kind of therapy that gradually immunizes the patient against the allergens by increasing the patient’s exposure to them. The patient was also advised to avoid wheat products in the diet for the time being, and to carry an epinephrine pen with him as far as possible, so that he could inject himself in the outer thigh if the above reaction occurred again. The patient actively cooperated with the treatment and strictly followed the doctor’s instructions, and was asked to come to the hospital for review every six months. Third, the effect of treatment The patient complied with the doctor’s instructions for more than 2 years, did not appear again allergic reactions, and severe allergy-induced anaphylactic shock, and allergic rhinitis and urticaria attacks of severity and frequency than the pre-treatment significantly better. The quality of life scores of rhinitis and conjunctivitis and the symptom control score of urticaria indicated that the symptoms had significantly improved. The patient’s skin test positivity for dust mite, Artemisia absinthium, Humulus japonicus, and wheat decreased from the previous level, serum sIgE decreased slightly from the previous level, and total IgE decreased significantly from the previous level. IV. Precautions We are glad that the patient did not have any allergic reaction in more than 2 years of treatment, but we suggest that the patient should continue to avoid wheat products in his diet and continue to have specific immunotherapy for dust mite and Artemisia absinthium, so as to avoid the reoccurrence of allergic reaction, which would lead to the free sIgE in the serum to meet the relevant allergens again and activate the mast cells and basophils to release particles, and then the patient would have chronic allergy (allergic rhinitis) or acute allergy (severe allergic reaction). ) or acute allergy (severe allergic reaction/anaphylaxis). The above treatment regimen should be adhered to as prescribed by the physician until allergen-specific skin prick and serum sIgE are negative. In addition, one should avoid eating allergenic food in daily life, avoid contacting irritating substances that can easily cause allergy, and wear masks and other protective products in the season of poplar and willow flakes to avoid causing allergic rhinitis and other symptoms. There are many causes of severe allergic reactions or anaphylaxis, the four most common causes are inhalation allergens, food allergens, drug allergens and venom allergens, so we should pay attention to our own prevention in our daily life and avoid contact with allergy-prone substances and foods. If severe allergic reactions occur and cause anaphylaxis, it is important to seek prompt medical attention, otherwise it can be life-threatening. As in this article it seems that the specific immunotherapy of dust mite and Artemisia absinthium has little therapeutic effect on exercise-induced wheat-dependent food allergy, but the specific immunotherapy has a role in stabilizing the cell membranes of mast cells and basophils. Therefore, for patients prone to severe allergic reactions, it is necessary to seek medical treatment to let the doctor know the overall state of allergic reactions, and to make clear whether there is a combination of other allergic diseases. Comprehensive treatment.