Alpha-Gal: A Delayed Onset of Anaphylaxis and Uncovering the Cause

Berry, Diane; Britton, Laura E.; Joseph, Letha M.; Jessup, Ann

doi:10.1016/j.jen.2019.03.001

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…6 Symptoms may include intensive generalized pruritus, flushing, diffuse urticaria, a sense of impending doom, angioedema of the throat and mouth, dysphagia, dysarthria, tachycardia, wheezing, gastrointestinal pain, nausea, and vomiting, sudden weakness, hypotension, and syncope. 7 AGS symptom manifestation may depend on lipid content and, thus, not present with anaphylaxis to every red meat ingestion. 5 The delayed anaphylaxis may be attributed to the rate of lipid absorption that requires conversion and processing of lipids to chylomicrons and then to low-density lipoproteins.…”

Section: Discussionmentioning

confidence: 99%

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No Bull: A Case of Alpha-Gal Syndrome Associated With Buffalo Meat Sensitivity

Rowane

Valencia

Stewart-Bates

et al. 2019

Allergy�Rhinol (Providence)

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Introduction: Alpha (⍺)-gal syndrome (AGS) is an immunoglobulin E (IgE) antibody response against the glycoprotein carbohydrate galactose-⍺-1,3-galactose-b-1-(3)4-N-acetylglucosamine-R (Gal⍺-1,3Galb1-(3)4GlcNAc-R or ⍺-gal) that is present in Ixodida (tick) saliva and noncatarrhine mammals as well as cetuximab, antivenom, and the zoster vaccine. The most frequently observed anaphylactic reactions in AGS are observed after beef, pork, lamb, and deer meat consumption. We present the first case of anaphylaxis to buffalo meat. Case Report: A 55-year-old man presented with a history of recurrent urticaria that only developed approximately 7 hours after buffalo consumption. The patient denied history of Ixodidae bites but admitted to frequent hiking outdoors. Anti-⍺-1,3gal IgE was positive (30.80 kU/L). The patient was advised to strictly avoid red meat. Discussion: The prevalence of AGS has been increased in all continents in the past decade, and several Ixodidae species have been associated with this hypersensitivity. The list of IgE-mediated reactions to various types of meat has expanded to kangaroo, whale, seal, and crocodile, although these have not been associated with AGS. van Nunen only cautioned against consumption of exotic meats, such as buffalo, but no published case report describes AGS associated with anaphylaxis to this type of meat. Conclusion: AGS is a mammalian meat allergy that has been increasingly prevalent worldwide, especially in Ixodidae endemic regions of Australia and the United States. Multiple AGS case reports published in the past decade demonstrate rapidly increasing understanding of underlying mechanisms provoking ongoing sensitization to help devise management strategies and dietary information. We offer the first case report of delayed anaphylaxis to buffalo meat.

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Section: Discussionmentioning

confidence: 99%

“…AGS was verified by high ⍺-gal IgE to beef, mutton, and pork. 7 Mabelane and Ogunbanjo described a South African cohort that reported rapid hypersensitivity responses (within 45 min) and a prominence of gastrointestinal symptoms, following beef sausage ingestion. 5 Abreu et al detailed the second record of AGS in Portugal.…”

Section: Discussionmentioning

confidence: 99%

No Bull: A Case of Alpha-Gal Syndrome Associated With Buffalo Meat Sensitivity

Rowane

Valencia

Stewart-Bates

et al. 2019

Allergy�Rhinol (Providence)

View full text Add to dashboard Cite

show abstract

“…2,3 If not treated rapidly and appropriately, anaphylaxis can be fatal. 4 An unknown cause of an allergic reaction such as AGA may delay timely treatment and leave the patient unaware of triggers to avoid. 5 The tick Amblyomma americanum, also known as the lone star tick, is the only known vector in the US that triggers AGA.…”

Section: Introductionmentioning

confidence: 99%

“…Anaphylaxis is typically associated with certain types of food, drugs, and environmental allergic reactions; however, it may also be associated with changes of the skin and mucosa 2,3. If not treated rapidly and appropriately, anaphylaxis can be fatal 4. An unknown cause of an allergic reaction such as AGA may delay timely treatment and leave the patient unaware of triggers to avoid 5…”

Section: Introductionmentioning

confidence: 99%