GALACTOSE-A-1,3-GALACTOSE SENSITIZATION AND THE A-GAL SYNDROME: CHARACTERISTICS OF SUBJECTS SEEKING EMERGENCY CARE

Abstract

Introduction Galactose -α-1,3- galactose (α-Gal) is an oligosaccharide of non-primate mammals and the culprit allergen in a syndrome of delayed anaphylaxis to mammalian meat (ie, α-Gal syndrome). We sought to describe the clinical presentations of a large cohort of subjects from Central Virginia, with or without IgE to α-Gal, who presented for emergent care for allergic reactions. Methods A detailed questionnaire regarding clinical reactions was completed by patients who received care at a Virginia allergy clinic and who reported a history of anaphylaxis or urticaria. Many, but not all, related their reactions to mammalian meat. Serum was obtained and total IgE and α-Gal specific IgE (sIgE) were measured by ImmunoCAP. Results Of 408 patients who completed the survey, 224 had sought urgent care (195 of which were in the emergency department) for allergic reactions. Of these, 191 were α-Gal sIgE positive, of whom 82% perceived an association between consumption of mammalian meat and allergic symptoms. When compared to non-sensitized subjects, α-Gal sensitized subjects were more commonly male (45% vs. 18%, p2 hours after a perceived trigger (82% vs. 25%, p Conclusions The α-Gal syndrome is commonly adult-onset, has a characteristic delay of onset >2 hours following mammalian meat ingestion, and frequently results in presentation for emergent medical care.