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Red meat allergy: Understanding the diagnosis of an alpha-Gal induced red meat allergy

Susanne, a 52-year-old with no history of allergy, visits her healthcare provider after following a recent emergency admission after waking up at 1 a.m. with generalized urticaria and anaphylaxis. She had eaten beef and salad with wine for dinner the evening before.

Susanne's healthcare provider conducts a full clinical history and physical examination and decides to test for alpha-Gal mediated meat allergy.    
 

A woman with no history of allergy visits her healthcare provider after experiencing generalized urticaria and anaphylaxis.

Patient History

Family History

  • None

Susanne’s Personal History

  • No history of allergies and no previous reactions. 
  • Has had two tick bites.

Susanne’s ImmunoCAP™ Test Results

These results, together with this patient's case history and symptoms, help confirm the diagnosis.  

 

Follow Up after ER visit for Tryptase levels:

Tryptase Level

Results

Normal

3

At ER

14.5

 

Transient elevation in tryptase confirms activation of mast cells.

 

ImmunoCAP Test Results (KUA/I)

Test

Type

Susanne's Results

Beef

Whole Allergen

 6.8 


Pork

Whole Allergen

6.5 

Lamb 

Whole Allergen

6.2 


alpha-Gal

Allergen Component

 26.7

Differential Diagnosis

Her test results show that Susanne is sensitized to beef, pork, and lamb. She has high levels of IgE to alpha-Gal and is at risk for systemic reactions when eating red meat.1

REFINED DIAGNOSIS

  • Her case history together with the test results support a diagnosis of alpha-Gal induced red meat allergy. 

HEALTHCARE PROVIDER MANAGEMENT PLAN

Susanne's healthcare provider:

  • Advises her to avoid any form of red meat. 
  • Advises her to be aware of hidden meat products like gelatin in candies and drugs. Gelatins are produced from pork and may cause reactions.
  • Prescribes her an adrenaline autoinjector in case of an emergency reaction.
  • Also advises her to avoid further tick bites if possible. 
  • Informs her that co-factors like exercise, alcohol, and NSAID can worsen her alpha-Gal reactions.

FOLLOW UP

  • Susanne is seen by her healthcare provider one year later. She has had no further episodes, and is doing well.

The people, places, and events depicted in these case studies and photographs do not represent actual patients, nor are they affiliated in any way with Thermo Fisher Scientific.

References
  1. Steinke JW, Platts-Mills TAE, Commins SP. The alpha gal story: Lessons learned from connecting the dots. The Journal of allergy and clinical immunology. 2015;135(3):589-597. doi:10.1016/j.jaci.2014.12.1947.