Alpha-Gal-Syndrom

Fischer, Jörg; Reepschläger, T; Schricker, Thomas; Raap, Ulrike

doi:10.1007/s00105-022-04943-4

Cited by 4 publications

(1 citation statement)

References 30 publications

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“…A combination of cetuximab, encorafenib, and binimetinib was shown to result in a significantly longer overall survival and a higher response rate than standard therapy in patients with metastatic colorectal cancer with the BRAF V600E mutation who had had disease progression after one or two previous regimens [3]. The galactose-α-1,3-galactose (α-gal) syndrome is triggered by specific immunoglobulin E (IgE) directed against the immunogenic sugar α-gal, typically found in mammalian meat, milk, and products derived thereof, potentially resulting in anaphylaxis [4]. Here, we report a case of cardiac arrest caused by an anaphylactic reaction to an initial dose of cetuximab.…”

Section: Introductionmentioning

confidence: 99%

Cardiac Arrest Induced by an Anaphylactic Reaction Associated With the First Dose of Cetuximab

Hane¹,

Ito²,

Ishikura³

et al. 2022

Cureus

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Cetuximab is a chimeric mouse-human monoclonal antibody biologic used for the treatment of epidermal growth factor receptor-positive colorectal cancer and head and neck cancer. The incidence of severe anaphylaxis after infusion of cetuximab is a rare but fatal complication. Galactose-α-1,3-galactose (α-gal), a side-chain component in cetuximab, can cause the α-gal syndrome, an allergic cross-reaction to the α-gal contained in mammalian muscle. Here, we report a case of cardiac arrest induced by an anaphylactic reaction from cetuximab infusion. After the initial dosing of cetuximab in an outpatient setting, the patient developed sudden cardiac arrest. Flushing of the skin and bronchoconstriction led to the diagnosis of a severe anaphylactic reaction, whereupon he was treated with repeated doses of epinephrine, steroids, and continuous epinephrine infusion. The patient responded well to initial treatment, leading to a full recovery. The patient's history and subsequent blood tests did not show any meat allergies. As an increasing number of patients receive chemotherapy as outpatients, it is important to be aware of the possibility of severe allergic reactions induced by these drugs.

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Section: Introductionmentioning

confidence: 99%

Cardiac Arrest Induced by an Anaphylactic Reaction Associated With the First Dose of Cetuximab

Hane¹,

Ito²,

Ishikura³

et al. 2022

Cureus

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Klimawandel und Typ-I-Allergien im Beruf

Raulf

2023

Dermatologie

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Current and Future Strategies for the Diagnosis and Treatment of the Alpha-Gal Syndrome (AGS)

Vaz-Rodrigues¹,

Mazuecos²,

Fuente³

2022

JAA

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The α-Gal syndrome (AGS) is a pathognomonic immunoglobulin E (IgE)-mediated delayed anaphylaxis in foods containing the oligosaccharide galactose-α-1,3-galactose (α-Gal) such as mammalian meat or dairy products. Clinical presentation of AGS can also comprise immediate hypersensitivity due to anticancer therapy, gelatin-containing vaccines or mammalian serum-based antivenom. The IgE initial sensitization is caused by hard-bodied tick bites and symptomatic individuals typically develop delayed pruritus, urticaria, angioedema, anaphylaxis, malaise or gut-related symptoms. Due to inapparent presentation, delayed reactions and a wide variety of patients´ clinical history, the AGS diagnosis and treatment remain challenging. This review covers not only current diagnostic methods used for AGS such as the skin prick test (SPT), the oral food challenge (OFC), anti-α-Gal IgE levels measurement and the basophil activation test (BAT), but also potentially relevant next-generation diagnostic tools like the mast cell activation test (MAT), the histamine-release (HR) assay, omics technologies and model-based reasoning (MBR). Moreover, it focuses on the therapeutical medical and non-medical methods available and current research methods that are being applied in order to elucidate the molecular, physiological and immune mechanisms underlying this allergic disorder. Lastly, future treatment and preventive tools are also discussed, being of utmost importance for the identification of tick salivary molecules, with or without α-Gal modifications, that trigger IgE sensitivity as they could be the key for further vaccine development. Bearing in mind climate change, the tick-host paradigm will shift towards an increasing number of AGS cases in new regions worldwide, which will pose new challenges for clinicians in the future.

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Alpha-Gal-Syndrom

Cited by 4 publications

References 30 publications

Cardiac Arrest Induced by an Anaphylactic Reaction Associated With the First Dose of Cetuximab

Cardiac Arrest Induced by an Anaphylactic Reaction Associated With the First Dose of Cetuximab

Klimawandel und Typ-I-Allergien im Beruf

Current and Future Strategies for the Diagnosis and Treatment of the Alpha-Gal Syndrome (AGS)

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