Red Meat Allergy Associated with NSTEMI

Hanna M. Crow^1, , Tiffany Samples¹ and Jane T. Purser²

¹Department of Internal Medicine, Oklahoma State University Medical Center, Tulsa, Oklahoma, USA

²Department of Allergy and Immunology, University of Oklahoma, Tulsa, Oklahoma, USA

Cite this paper

Hanna M. Crow, Tiffany Samples and Jane T. Purser. Red Meat Allergy Associated with NSTEMI. American Journal of Medical Case Reports. 2019; 7(1):13-15. doi: 10.12691/AJMCR-7-1-4

Abstract

Alpha-gal syndrome, also known as mammalian meat allergy, is characterized by a hypersensitivity reaction to galactose-alpha-1,3-galactose. Reactions typically manifest hours after consumption of red meat products such as beef, pork, and lamb. We describe the case of a 64-year-old male resident of rural Oklahoma who presented with anaphylaxis and myocardial infarction. The patient suffered complications that were attributed to porcine-derived heparin in the setting of undiagnosed alpha-gal syndrome. We describe the clinical course of this patient that lead to the diagnosis of alpha-gal syndrome to raise awareness of this disease.

Keywords

Alpha gal, mammalian meat allergy, heparin

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Commins, S. P., & Platts-Mills, T. A. E. (2009). Anaphylaxis syndromes related to a new mammalian cross-reactive carbohydrate determinant. The Journal of Allergy and Clinical Immunology, 124(4), 652-657.
[2]	Arslan Lied, G. (2017). Red meat allergy induced by tick bites: A Norwegian case report. European Annals of Allergy and Clinical Immunology, 49(4), 186-188.
[3]	Van Nunen, S. A., O’Connor, K. S., Clarke, L. R., Boyle, R. X., & Fernando, S. L. (2009). An association between tick bite reactions and red meat allergy in humans. The Medical Journal of Australia, 190(9), 510-511.
[4]	Wickner, P. G., & Commins, S. P. (2014). The First 4 Central American Cases Of Delayed Meat Allergy With Galactose-Alpha-1,3-Galactose Positivity Clustered Among Field Biologists In Panama. The Journal of Allergy and Clinical Immunology, 133(2).
[5]	Commins, S. P., James, H. R., Kelly, L. A., Pochan, S. L., Workman, L.J., Perzanowski, M. S., Platts-Mills, T. A. E. (2011). The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-α-1,3-galactose. The Journal of Allergy and Clinical Immunology, 127(5), 1286-1293.e6.
[6]	O’Neil, B. H., Allen, R., Spigel, D. R., Stinchcombe, T. E., Moore, D. T., Berlin, J. D., & Goldberg, R. M. (2007). High Incidence of Cetuximab-Related Infusion Reactions in Tennessee and North Carolina and the Association With Atopic History. Journal of Clinical Orthodontics: JCO, 25(24), 3644-3648.
[7]	Kollmann, D., Nagl, B., Ebner, C., Emminger, W., Wöhrl, S., Kitzmüller, C.,Bohle, B. (2017). The quantity and quality of α-gal-specific antibodies differ in individuals with and without delayed red meat allergy. Allergy, 72(2), 266-273.
[8]	Maier, S., Chung, C. H., Morse, M., Platts-Mills, T., Townes, L., Mukhopadhyay, P., Trifan, O. C. (2015). A retrospective analysis of cross-reacting cetuximab IgE antibody and its association with severe infusion reactions. Cancer Medicine, 4(1), 36-42.
[9]	Tripathi, A., Commins, S. P., Heymann, P. W., & Platts-Mills, T. A. E. (2014). Delayed anaphylaxis to red meat masquerading as idiopathic anaphylaxis. The Journal of Allergy and Clinical Immunology in Practice, 2(3), 259-265.
[10]	Mullins, R. J., James, H., Platts-Mills, T. A. E., & Commins, S. (2012). Relationship between red meat allergy and sensitization to gelatin and galactose-α-1,3-galactose. The Journal of Allergy and Clinical Immunology, 129(5), 1334-1342.e1.
[11]	Steinke, J. W., Platts-Mills, T. A. E., & Commins, S. P. (2015). The alpha-gal story: lessons learned from connecting the dots. The Journal of Allergy and Clinical Immunology, 135(3), 589-596.
[12]	Kounis, N. G. (2006). Kounis syndrome (allergic angina and allergic myocardial infarction): a natural paradigm? International Journal of Cardiology, 110(1), 7-14.
[13]	Platts-Mills, T. A. E., Schuyler, A. J., Tripathi, A., & Commins, S. P. (2015). Anaphylaxis to the carbohydrate side chain alpha-gal. Immunology and Allergy Clinics of North America, 35(2), 247-260.
[14]	Thall, A., & Galili, U. (1990). Distribution of Gal alpha 1----3Gal beta 1----4GlcNAc residues on secreted mammalian glycoproteins (thyroglobulin, fibrinogen, and immunoglobulin G) as measured by a sensitive solidphase radioimmunoassay. Biochemistry, 29(16), 3959-3965.
[15]	Unal, D., Coskun, R., Demir, S., Gelincik, A., Colakoglu, B., & Buyukozturk, S. (2017). Successful beef desensitization in 2 adult patients with a delayed-type reaction to red meat. The Journal of Allergy and Clinical Immunology in Practice, 5(2), 502-503.