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Allergy. 2018 May;73(5):1131-1134. doi: 10.1111/all.13366. Epub 2017 Dec 27.

Identification of alpha-gal sensitivity in patients with a diagnosis of idiopathic anaphylaxis.

Author information

1
Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
2
Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, VA, USA.
3
Departments of Internal Medicine and Pediatrics, University of Tennessee College of Medicine, Germantown, TN, USA.

Abstract

IgE antibodies (Ab) specific to galactose-α-1,3-galactose (alpha-gal) are responsible for a delayed form of anaphylaxis that occurs 3-6 hours after red meat ingestion. In a unique prospective study of seventy participants referred with a diagnosis of idiopathic anaphylaxis (IA), six (9%) were found to have IgE to alpha-gal. Upon institution of a diet free of red meat, all patients had no further episodes of anaphylaxis. Two of these individuals had indolent systemic mastocytosis (ISM). Those with ISM had more severe clinical reactions but lower specific IgE to alpha-gal and higher serum tryptase levels, reflective of the mast cell burden. The identification of alpha-gal syndrome in patients with IA supports the need for routine screening for this sensitivity as a cause of anaphylaxis, where reactions to alpha-gal are delayed and thus may be overlooked.

KEYWORDS:

alpha-galactose; anaphylaxis; clonal; mastocytosis

PMID:
29161766
DOI:
10.1111/all.13366
[Indexed for MEDLINE]

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