Delayed anaphylaxis due to Alpha-gal allergy: A modified desensitization protocol with red meat in an adult patient
Tepetam FM, Yegin Katran Z, Bayraktar Barın R, Çakmak Uğurlu B
Tuberkuloz ve toraks · 8 citas
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Publicación
- Publicado
- 2023-09-22 · Tuberk Toraks · vol. 71 · número 3 · págs. 318–324
- Editorial
- Ankara University
- Citado
- 8 citas · más que el 77% de estudios similares · 1.1× el promedio de su campo
- Referencias
- 24 trabajos
- Acceso
- Acceso abierto (publicación gratuita)
- Áreas de investigación
- Food Allergy and Anaphylaxis Research · Allergic Rhinitis and Sensitization · Contact Dermatitis and Allergies
- Palabras clave
- Desensitization (medicine), Red meat, Medicine, Anaphylaxis, Allergy, Food allergy, Elimination diet, Immunoglobulin E, Oral allergy syndrome, Immunology, Food science, Internal medicine, Biology, Pathology, Antibody
- MeSH
- animals, mammals, humans, anaphylaxis, food hypersensitivity, immunoglobulin e, quality of life, adult, child, tick bites, red meat
4 autores
- Fatma Merve Tepetam🇰🇭🇺🇸🇹🇷🇦🇬 · autor de correspondenciaUniversity of Health Science; ENT and Allergy; Sağlık Bilimleri Üniversitesi; University of Health Sciences Antigua
- Zeynep Yeğin Katran🇰🇭🇹🇷🇦🇬University of Health Science; Sağlık Bilimleri Üniversitesi; University of Health Sciences Antigua
- Ravza Bayraktar Barın🇰🇭🇺🇸🇹🇷🇦🇬University of Health Science; ENT and Allergy; Sağlık Bilimleri Üniversitesi; University of Health Sciences Antigua
- Betül Çakmak Uğurlu🇰🇭🇹🇷🇦🇬University of Health Science; Sağlık Bilimleri Üniversitesi; University of Health Sciences Antigua
Resumen
El texto original del estudio, en el idioma en que se publicó.
Alpha-gal allergy is the sensitization to Alpha-gal present in saliva when a tick bites and the development of an IgE-mediated reaction to Alpha-gal also present in red meat by cross-reactivity. In contrast to other food allergies, symptoms occur as late as 2-6 hours after a meal. Prick to prick testing with nonmammalian meat in combination with cooked mammalian meat is recommended for diagnosis. However, the main diagnostic test is Alpha-gal sIgE> 0.1 IU/mL. The primary recommendation in patients with Alpha-gal syndrome is to prevent new tick bites and avoid all mammalian meats. Since most of the dishes in our country's food culture contain red meat, elimination diet may adversely affect patients quality of life. In the management of these patients, the option of desensitization with red meat can be considered by evaluating the benefit-risk ratio together with the patient. Our patient with a history of tick bites and a reaction pattern ranging from urticaria to anaphylaxis two hours after meat consumption was evaluated for Alpha gal allergy. The patient was found to be positive by prick-to-prick with cooked red meat. In addition, the high level of Alpha-gal specific IgE (27.3 Ku/L) confirmed the Alpha-gal allergy, and the decision to apply desensitization with red meat was taken. There are only two literatures on this subject, one of which includes two adult cases and the other a single pediatric case. Since a reaction developed in the fifth step of the 27-step desensitization scheme (Ünal et al.), which we took as a reference, which led to a dose increase of more than 100 times, we modified the protocol by using an intermediate steps. We repeated the prick-to-prick test with red meat after desensitization in our case who successfully completed the modified desensitization protocol. Observation of more than half reduction in test edema diameter concretely supports the success of our modified desensitization protocol.
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