Investigation into the ?-Gal Syndrome: Characteristics of 261 Children and Adults Reporting Red Meat Allergy.

ABSTRACT: BACKGROUND:Red meat allergy has historically been understood as a rare disease of atopic children, but the discovery of the "?-Gal syndrome," which relates to IgE to the oligosaccharide galactose-?-1,3-galactose (?-Gal), has challenged that notion. OBJECTIVE:To describe the clinical and immunologic characteristics of a large group of subjects with self-reported allergy to mammalian meat. METHODS:This was an observational study of 261 children and adults (range, 5-82 years) who presented for evaluation for allergic reactions to mammalian meat. Results were based on serum assays and a detailed questionnaire. RESULTS:?-Gal specific IgE ? 0.35 IU/mL was detected in 245 subjects and symptom onset occurred ?2 hours after eating mammalian meat in 211 (81%). Component testing supported a diagnosis of ?-Gal syndrome in 95%, pork-cat syndrome in 1.9%, and primary beef allergy in 1.1%. Urticaria was reported by 93%, anaphylaxis by 60%, and gastrointestinal symptoms by 64%. Levels of IgE and IgG specific to ?-Gal were similar in subjects who reported early- or delayed-onset symptoms, and in those with and without anaphylaxis. Levels of ?-Gal specific IgE and severity of reactions were similar among those with and without traditional atopy, and among children (n = 35) and adults (n = 226). Blood group B trended toward being under-represented among ?-Gal-sensitized subjects; however, ?-Gal specific IgE titers were high in symptomatic cases with B-antigen. CONCLUSIONS:The ?-Gal syndrome is a regionally common form of food allergy that has a characteristic but not universal delay in symptom onset, includes gastrointestinal symptoms, can develop at any time in life, and is equally common in otherwise nonatopic individuals.

SUBMITTER: Wilson JM 

PROVIDER: S-EPMC6993919 | biostudies-literature | 2019 Sep - Oct

REPOSITORIES: biostudies-literature