(Disclaimer: This article is for scientific use only. To protect patient privacy, the relevant information in the following content has been processed) Abstract: Allergic reactions are everyday allergic reactions. 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, or 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 anaphylaxis. [Basic information] Female, 33 years old [Disease type] Anaphylaxis [Hospital] Wuhan University Central South Hospital [Consultation date] April 2020 [Treatment plan] Allergen detection + allergen avoidance + carrying epinephrine pen + allergen-specific immunotherapy (dust mite, Artemisia absinthium, Humulus humilis) [Treatment period] 2 years, allergen review every 6 months [Treatment effect] The patient did not have any more severe Allergic reaction and anaphylaxis, allergic rhinitis, urticaria symptoms significantly relieved I. Initial interview Patient Xiaomei had sudden onset of leg weakness, panic, itchy nose, itchy scalp, itchy flushed skin all over the body, sneezing and runny nose when she went to the toilet at 9:00 a.m. on November 12, 2018, the patient stopped exercising and took oral cetirizine without relief, and about 3-5 minutes later further developed unbearable itchy palms, The patient’s family members called 120 and sent him to the emergency room. In addition to allergic rhinitis, urticaria and itchy skin, he had no other underlying diseases and was considered to be in anaphylaxis caused by allergy. At that time, epinephrine was administered intramuscularly and the symptoms gradually subsided. The above condition occurred 5 times from 2018 to 2020, and all but 1 time resolved on its own, and 4 times were treated by calling 120 emergency room. To further clarify the cause of the 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 humilis, and wheat, with a total IgE of 1400 KU/l. Combined with the patient’s medical history, each time the allergic reaction occurred after eating wheat products, the diagnosis of wheat-dependent exercise-induced severe allergic reaction and anaphylaxis was established. II. Treatment history Since the patient had a history of allergic rhinitis and chronic urticaria, it was considered to be caused by allergy to dust mite, Artemisia absinthium and Humulus humilis, and the patient was advised to undergo specific immunotherapy for dust mite, Artemisia absinthium and Humulus humilis, i.e., a therapy that gradually makes the patient immune to the allergen by increasing the patient’s exposure to it. He was also advised to avoid wheat products in his diet for the time being, to try to carry an epinephrine pen with him, and to inject himself on the outer thigh if the above reaction occurs again. The patient actively cooperated and strictly followed the doctor’s prescription, and was asked to come to the hospital for review every six months. The patient complied with the medical prescription for more than 2 years and did not have any more allergic reactions and anaphylaxis caused by severe allergy, and the severity and frequency of allergic rhinitis and urticaria attacks were significantly better than before treatment. The quality of life scores for rhinitis and conjunctivitis and the symptom control score for urticaria all indicated significant improvement in symptoms. The patient’s dust mite, Artemisia absinthium, Humulus humilis, and wheat skin tests were less positive than before, the serum sIgE was slightly lower than before, and the total IgE was significantly lower than before. However, it is recommended that the patient continue to avoid wheat products in his diet and continue specific immunotherapy with dust mites and Artemisia absinthium to avoid the reoccurrence of allergic reactions, resulting in the free sIgE in the serum encountering the relevant allergens again, activating mast cells and basophils to release granules again and developing 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 pricks and serum sIgE reach negativity. In addition, one should avoid eating allergy-prone foods in daily life, avoid contact with irritants that can easily cause allergy, and wear protective products such as masks when encountering the poppy season to avoid causing symptoms such as allergic rhinitis. V. Personal insight 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 you should pay attention to your own prevention in daily life and avoid contact with substances and foods that can easily cause allergies. If a serious allergic reaction occurs and causes anaphylaxis, seek medical attention promptly, otherwise it will 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 some effect on stabilizing the cell membranes of mast cells and basophils, so for patients who are prone to severe allergic reactions, they need to seek medical attention to let the doctor understand the overall allergic reaction status and clarify whether other allergic diseases are combined and Comprehensive management.