Clinical Practice: Clinical Vignettes

Journal of General Internal Medicine

, Volume 28, Issue 2, pp 322-325

A Peculiar Cause of Anaphylaxis: No More steak?

The Journey to Discovery of a Newly Recognized Allergy to Galactose-alpha-1,3-galactose Found in Mammalian Meat
  • Susan E. WolverAffiliated withGeneral Internal Medicine, Virginia Commonwealth University Email author 
  • , Diane R. SunAffiliated withDivision of Rheumatology, Allergy and Immunology, Virginia Commonwealth University
  • , Scott P. ComminsAffiliated withAsthma and Allergic Diseases Center, The University of Virginia
  • , Lawrence B. SchwartzAffiliated withDivision of Rheumatology, Allergy and Immunology, Virginia Commonwealth University

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ABSTRACT

In recent years, a newly recognized allergic disease has been uncovered, and seemingly idiopathic causes of anaphylaxis now have an explanation. Individuals bitten by the lone star tick may develop IgE antibodies to the carbohydrate galactose-α-1,3-galactose (alpha-gal). Upon exposure of sensitized subjects to mammalian meat containing alpha-gal on glycoproteins or glycolipids, delayed anaphylaxis may ensue, often three to six hours after ingestion.1 Many of these individuals have negative allergy skin prick tests to meat, further obscuring the diagnosis. With the recent development of IgE alpha-gal tests, the clinical diagnosis can be confirmed in the laboratory.

KEY WORDS

allergy anaphylaxis immunology tick meat