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A tick-acquired red meat allergy

Published:October 16, 2017DOI:https://doi.org/10.1016/j.ajem.2017.10.044

      Abstract

      Allergic reaction is a common clinical picture in the Emergency Department (ED). Most allergic reactions are from food or drugs. A detailed history is an integral aspect of determining the causative agent of an allergy. Galactose-alpha-1,3-galactose (alpha-gal) allergy is a tick-acquired red meat allergy that causes delayed-onset allergic reaction or anaphylaxis due to molecular mimicry. Alpha-gal allergy may not be widely known as a cause of allergic reactions. Lack of universal awareness of this phenomenon in the ED and Urgent Care setting could lead to misdiagnosis, or delayed diagnosis. Subsequently, lack of proper instruction to avoid red meat could put patients at risk for future attacks with morbidity or mortality. We report three cases of allergic reaction presumed from red meat consumption secondary to alpha-gal allergy.

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      References

        • Clark S.
        • Camargo Jr., C.A.
        Epidemiology of anaphylaxis.
        Immunol Allergy Clin North Am. 2007; 27: 145-163https://doi.org/10.1016/j.iac.2007.03.002
        • Commins S.P.
        • et al.
        Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-alpha-1,3-galactose.
        J Allergy Clin Immunol. 2009; 123: 426-433https://doi.org/10.1016/j.jaci.2008.10.052
        • Flaherty M.G.
        • Kaplan S.J.
        • Jerath M.R.
        Diagnosis of life-threatening alpha-gal food allergy appears to be patient driven.
        J Prim Care Community Health. 2017; 0 (2150131917705714)
        • Maier S.
        • et al.
        A retrospective analysis of cross-reacting cetuximab IgE antibody and its association with severe infusion reactions.
        Cancer Med. 2015; 4: 36-42https://doi.org/10.1002/cam4.333
        • Commins S.P.
        • Platts-Mills T.A.
        Delayed anaphylaxis to red meat in patients with IgE specific for galactose alpha-1,3-galactose (alpha-gal).
        Curr Allergy Asthma Rep. 2013; 13: 72-77https://doi.org/10.1007/s11882-012-0315-y
        • O'Neil B.H.
        • et al.
        High incidence of cetuximab-related infusion reactions in Tennessee and North Carolina and the association with atopic history.
        J Clin Oncol. 2007; 25: 3644-3648https://doi.org/10.1200/JCO.2007.11.7812
        • Steinke J.W.
        • Platts-Mills T.A.
        • Commins S.P.
        The alpha-gal story: lessons learned from connecting the dots.
        J Allergy Clin Immunol. 2015; 135 (quiz 597): 589-596
        • Chung C.H.
        • et al.
        Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose.
        N Engl J Med. 2008; 358: 1109-1117https://doi.org/10.1056/NEJMoa074943
        • Commins S.P.
        • et al.
        The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-alpha-1,3-galactose.
        J Allergy Clin Immunol. 2011; 127 (e1286): 1286-1293