When eating meat becomes a danger

Introduction:

Anaphylactic reactions are systemic allergic symptoms that can escalate to life-threatening levels.

In addition to protein-mediated allergic reactions, α-Gal, an ubiquitous sugar structure on cells and tissues of all mammals except primates, is now also associated as a causal allergen with severe anaphylaxis and urticaria. Particular is the temporal latency of the allergic reactions of 3 – 6 hours.

Casuistry:

A 72-year-old patient alerted the emergency physician due to early morning nausea, cold sweat, swelling of the extremities and a small patchy exanthema. The doctor diagnosed a hypotension on arrival. After immediate therapy with adrenalin, prednisolone and ranitidine, the symptoms were completely reduced.

Findings:

Anamnestically a fragrance intolerance is known. He had taken kidney stew and avocado in the evening. The skin prick test with the standard allergens was inconspicuous. Blood tests showed a total IgE of 87.3 kU/L, a CAP class 0 for avocado and a specific IgE for α-Gal-(galactose-alpha-1,3-galactose thyroglobulin) cattle of 10.4 kU/L (CAP class 3). Confirmation was provided by a positive oral provocation test with beef. Accordingly, the avoidance of mammalian meat and its products (gelatine etc.) was recommended and an emergency set was prescribed after appropriate advice.

Conclusions:

Especially delayed anaphylactic reactions should lead to a α-Gal sensitization. The detailed collection of the anamnesis as well as the knowledge and use of molecular allergy diagnostics are the key to a focused allergological therapy concept.

Publication History

Publication Date:
23 April 2019 (online)