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Delayed anaphylaxis to red meat masquerading as idiopathic anaphylaxis.
J Allergy Clin Immunol Pract. 2014 May-Jun; 2(3):259-65.JA

Abstract

Anaphylaxis is traditionally recognized as a rapidly developing combination of symptoms that often includes hives and hypotension or respiratory symptoms. Furthermore, when a specific cause is identified, exposure to this cause is usually noted to have occurred within minutes to 2 hours before the onset of symptoms. This case is of a 79-year-old woman who developed a severe episode of anaphylaxis 3 hours after eating pork. Before 2012, she had not experienced any symptoms after ingestion of meat products. Delayed anaphylaxis to mammalian meat has many contrasting features to immediate food-induced anaphylaxis. The relevant IgE antibody is specific for the oligosaccharide galactose-alpha-1,3-galactose, a blood group substance of nonprimate mammals. There is evidence from Australia, Sweden, and the United States that the primary cause of this IgE antibody response is tick bites. These bites characteristically itch for 10 days or more. Diagnosis can be made by the presence of specific IgE to beef, pork, lamb, and milk, and the lack of IgE to chicken, turkey, and fish. Skin prick tests (but not intradermal tests) generally are negative. Management of these cases, now common across the southeastern United States, consists of education combined with avoidance of both ingestion of red meat and further tick bites.

Authors+Show Affiliations

Asthma and Allergic Diseases Center, University of Virginia Medical Center, Charlottesville, Va.Asthma and Allergic Diseases Center, University of Virginia Medical Center, Charlottesville, Va.Asthma and Allergic Diseases Center, University of Virginia Medical Center, Charlottesville, Va.Asthma and Allergic Diseases Center, University of Virginia Medical Center, Charlottesville, Va. Electronic address: tap2z@virginia.edu.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

24811014

Citation

Tripathi, Anubha, et al. "Delayed Anaphylaxis to Red Meat Masquerading as Idiopathic Anaphylaxis." The Journal of Allergy and Clinical Immunology. in Practice, vol. 2, no. 3, 2014, pp. 259-65.
Tripathi A, Commins SP, Heymann PW, et al. Delayed anaphylaxis to red meat masquerading as idiopathic anaphylaxis. J Allergy Clin Immunol Pract. 2014;2(3):259-65.
Tripathi, A., Commins, S. P., Heymann, P. W., & Platts-Mills, T. A. (2014). Delayed anaphylaxis to red meat masquerading as idiopathic anaphylaxis. The Journal of Allergy and Clinical Immunology. in Practice, 2(3), 259-65. https://doi.org/10.1016/j.jaip.2014.02.017
Tripathi A, et al. Delayed Anaphylaxis to Red Meat Masquerading as Idiopathic Anaphylaxis. J Allergy Clin Immunol Pract. 2014 May-Jun;2(3):259-65. PubMed PMID: 24811014.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Delayed anaphylaxis to red meat masquerading as idiopathic anaphylaxis. AU - Tripathi,Anubha, AU - Commins,Scott P, AU - Heymann,Peter W, AU - Platts-Mills,Thomas A E, PY - 2014/01/13/received PY - 2014/02/25/revised PY - 2014/02/26/accepted PY - 2014/5/10/entrez PY - 2014/5/9/pubmed PY - 2015/1/15/medline KW - Anaphylaxis KW - Delayed reaction to red meat KW - Galactose-alpha-1,3-galactose SP - 259 EP - 65 JF - The journal of allergy and clinical immunology. In practice JO - J Allergy Clin Immunol Pract VL - 2 IS - 3 N2 - Anaphylaxis is traditionally recognized as a rapidly developing combination of symptoms that often includes hives and hypotension or respiratory symptoms. Furthermore, when a specific cause is identified, exposure to this cause is usually noted to have occurred within minutes to 2 hours before the onset of symptoms. This case is of a 79-year-old woman who developed a severe episode of anaphylaxis 3 hours after eating pork. Before 2012, she had not experienced any symptoms after ingestion of meat products. Delayed anaphylaxis to mammalian meat has many contrasting features to immediate food-induced anaphylaxis. The relevant IgE antibody is specific for the oligosaccharide galactose-alpha-1,3-galactose, a blood group substance of nonprimate mammals. There is evidence from Australia, Sweden, and the United States that the primary cause of this IgE antibody response is tick bites. These bites characteristically itch for 10 days or more. Diagnosis can be made by the presence of specific IgE to beef, pork, lamb, and milk, and the lack of IgE to chicken, turkey, and fish. Skin prick tests (but not intradermal tests) generally are negative. Management of these cases, now common across the southeastern United States, consists of education combined with avoidance of both ingestion of red meat and further tick bites. SN - 2213-2201 UR - https://www.unboundmedicine.com/medline/citation/24811014/Delayed_anaphylaxis_to_red_meat_masquerading_as_idiopathic_anaphylaxis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-2198(14)00091-9 DB - PRIME DP - Unbound Medicine ER -