Abstract
Alpha-gal syndrome is characterized by delayed anaphylaxis to mammalian meats. Since its discovery, drug anaphylaxis related to the presence of alpha-gal residue has been described in patients with this syndrome. It involves heparins, which are of animal origin (beef lung and pig intestinal mucosa): up to 24 % of patients have anaphylaxis when administered intravenous heparin. Skin testing is a diagnostic tool in allergology. We investigated the proportion of heparin-positive skin tests in these patients. We retrospectively recorded the clinical and paraclinical data of patients sensitized to alpha-gal, consulting the allergology department of the University Hospital of Limoges between May 2020 and May 2021. We analyzed the proportion of heparin-positive skin tests in this population, as well as factors that may influence skin tests. Up to 1/3 of patients with alpha-gal syndrome have positive skin tests to standard heparins, and this doesn’t appear to be related to a history of anticoagulation. Heparin skin testing in this population would allow targeting patients at risk of anaphylaxis to tailor their management.
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