Mammalian meat allergy: Unexpected danger

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IT'S EARLY MORNING when Mr. M, 40, presents to the ED via ambulance after experiencing a possible allergic reaction at home. Treated immediately in the ED, he responded well to I.M. epinephrine, I.V. diphenhydramine, and I.V. methylprednisolone.1
He's now awake, alert, and oriented and in no obvious distress. His vital signs are stable and his signs and symptoms have resolved. He denies any known allergies, prescribed or over-the-counter medications, nutritional or herbal supplement use, or pertinent health history.
Mr. M states that he was awakened at about 0400 because of severe back “itching” and his wife stated his back “was covered in hives.” When he became short of breath and dizzy, she called the ambulance. On further questioning, the patient denies exposure to any obvious agents that could trigger an allergic reaction. However, when asked about recent meals, he says that he'd eaten a hamburger for dinner at about 1900. Given the absence of other likely allergens, the ED physician begins to suspect mammalian meat allergy.
The patient is referred to an allergist who, based on this presentation, also suspects mammalian meat allergy, formally called galactose-alpha-1,3-galactose (alpha-gal) sensitization.2 Skin testing is done to rule out other more common allergens. After serum confirmation testing, the patient is ultimately diagnosed with this unique allergy.
This article discusses how to assess patients who may be experiencing this disorder and how they're managed.
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