Alpha-gal syndrome: the first report in Poland

Abstract

alpha-gal syndrome is an immunoglobulin e (ige)-dependent allergy to galactose-α-1,3-galactose, resulting in a delayed anaphylactic reaction to red meat. the syndrome is causally linked to bites from ticks and associated with cross-reactivity to some drugs, e.g. cetuximab. although cases of alpha-gal allergy have already been reported in a few european countries, to our best knowledge, no cases have been reported so far in Central-eastern europe. in the current report, we describe a case of alpha-gal syndrome diagnosed in Poland, to highlight the fact that it may occur in new geographic areas. within three months, the described patient underwent five anaphylactic reactions with typical clinical manifestations. they developed a few hours after ingestion of red meat (pork, beef or mutton) and were preceded by tick bites. the level of specific ige antibodies to alpha-gal reached 72.6 kaU/l, whereas the levels of specific ige antibodies to other food allergens were within the reference range. as the onset of symptoms in this syndrome is usually delayed, numerous cases may be identified as idiopathic anaphylaxis, while early diagnosis is indispensable to avoid potentially life-threatening complications.

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

“…Some may also help with vomiting and nausea. Jackson et al 101 Kaplan and Carson 102 Khoury et al 103 Brzozowska et al 104 Anemüller et al 105 Corticosteroid Prednisone and methylprednisolone Used via oral or intravenous for more severe cases of allergic reaction (controls urticaria, angioedema and pruritis) Ghahramani and Temprano 106 Wen et al 107 Mast cell stabilizer Oral cromolyn solution Reduces persistent gastrointestinal symptoms when avoidance diet is insufficient Commins 42 Antiemetic Domperidone and metoclopramide Reduces vomiting and nausea Zhang et al 108 Saleem and Nilsson 109 Antispasmodic Dicycloverine and hyoscine Helps controlling abdominal pain Guillier et al 110 Brzozowska et al 104 Brenner and Lacy 111 Antidiarrheal Loperamide Used to stop or slow diarrhea (anti-motility drug) Kaplan and Carson 102 Bircher et al 112 Laxative Sennosides and bisacodyl Treat constipation by stimulating bowel movement Emmanuel et al 113 Saleem and Nilsson 109 …”

Clinical Use of the ImmunoCAP Inhibition Test in the Diagnosis of Meat Allergy Caused by a Tick Bite in an Adult Male with No Previous Atopic History

“…It seems that in Poland, tick-bite-related meat allergy is a rare clinical syndrome. Currently, only two studies on this subject are available [ 17 , 18 ]. However, it is not known whether this is really a rare syndrome of clinical symptoms or whether it is simply rarely recognized.…”

“…It seems that in Poland, AGS is a very rare phenomenon or its occurrence is very underdiagnosed. To date, only one case of AGS has been described in Poland [ 17 ]. There is also one population analysis of the occurrence of anti-α-Gal IgE antibodies in forest workers from the Podlasie region [ 18 ].…”

A Case Report on Alpha-gal Syndrome

“…AGS was first described in mid 2000s in southeastern United states [1,2] when a number of patients undergoing clinical trials of cetuximab (a medication used in patients with squamous-cell carcinoma of the head and neck metastatic colorectal cancer) showed allergic reactions during the first infusion [2]. A few years later multiple reports of hypersensitivity reactions to red meat products surfaced from the United States and Australia which triggered investigation into AGS [3].…”