Red Meat Allergy Symptoms, Diagnosis and Treatment
If you’re allergic to red meat, don’t let your sacrificial feast poison itself. Pay attention to the symptoms of red meat allergy during Eid al-Adha. Allergy symptoms can occur immediately after eating meat or as late as three to six hours. Founder of Istanbul Allergy and President of Allergy and Asthma Association Prof. Ahmet Akçay gave detailed information about red meat allergy.
What is a meat allergy?
Meat allergy is defined as the onset of life-threatening reactions such as low blood pressure and fainting, along with symptoms such as itching, hives, lip swelling, vomiting, abdominal pain and diarrhea, allergens in the body after eating meat.
What is the frequency?
Although the exact frequency of meat allergies is not known, it has been reported in 3-15% of children and 3% of adults with food allergies. The low prevalence of meat allergy may be partly attributable to the fact that most meats are eaten cooked and cooking often decreases the immunogenicity of allergens. The prevalence of beef allergy is the most commonly reported meat allergy. However, an allergy to beef can reach 20% in children allergic to cow’s milk.
The risk factors for developing a meat allergy are not fully defined and may differ depending on the allergen to which the patient is sensitive:
● A growing body of evidence suggests that multiple tick bites may be a risk factor for red meat allergy.
●A relationship has been noted between blood groups A and O and sensitivity to galactose-alpha-1,3-galactose (alpha-gal).
●Children with atopic dermatitis or cow’s milk allergy may be at increased risk.
●Patients allergic to gelatin may also be meat sensitive or clinically reactive.
Allergens That Cause Meat Allergies
Protein and carbohydrate allergens have been identified as responsible for IgE-mediated allergic reactions to meat. Serum albumins and immunoglobulins appear to be the major allergenic proteins in beef and other mammalian meats. Since these allergens are also found in milk, red meat allergy is often seen in children with milk allergy.
The other allergen is the alpha-gal allergen and is actually the blood group substance of mammals other than humans and monkeys. It is a substance in the structure of carbohydrates and is found in meats, kidneys, gelatin. This allergen combines with lipids and proteins and becomes an allergen.
How does a red meat allergy develop?
linked to milk allergy
Children with milk allergy can also develop beef allergy at a rate of 20% due to a cross-reaction, since milk allergenic proteins are also present in beef. With proper cooking, allergy symptoms may not be visible.
Due to a cat allergy
People allergic to cats may be allergic to pork due to a cross-reaction. People with pork allergies can be allergic to both beef and pork due to a cross reaction. Be careful if you are allergic to cat hair
Tied to tick bite
Ticks bite animals like cows and sheep and suck their blood. Alpha gal, a mammalian blood group allergen, is found in the stomachs of ticks. When ticks bite humans, these allergens infect people’s blood and cause antibodies to develop. As a result, allergy symptoms occur 3-6 hours after eating red meat.
What are the clinical symptoms?
Immunoglobulin E (IgE)-mediated and non-mediated forms of meat allergy have been described. According to these forms, the symptoms also differ.
Red meat allergy due to IgE usually develops due to milk allergy and symptoms of red meat allergy due to cat allergy occur within 2 hours of eating meat. Symptoms such as hives on the skin, swelling of the lips and tingling in the mouth occur especially after eating meat. Symptoms such as abdominal pain, vomiting and diarrhea may also be observed. Sometimes it can cause allergic rhinitis and asthma symptoms, as well as allergic shock, which is a life-threatening reaction in the form of a drop in blood pressure and fainting.
Those who are sensitized by tick bites usually show symptoms 3 to 6 hours after ingesting meat. Because after a tick bite you become sensitive to the alpha gal allergen. For beef containing alpha gal to develop an allergy, this allergen has the potential to cause an allergy by binding to a lipid or protein. Kazanis working. The reaction is therefore delayed.
Red meat allergy that is not IgE-related can present with symptoms like an allergic disease of the esophagus called eosinophilic esophagitis and red meat protein enterocolitis, which manifests as reflux, difficulty swallowing and chest pain that does not respond to treatment. In enterocolitis syndrome, recurrent vomiting and diarrhea symptoms are seen 3-4 hours after eating red meat.
Beef allergic patients may react to mutton or pork, but rarely to poultry or fish. People with red meat allergies may also develop allergies to cetuximab, gelatin, vaginal capsules, and vaccines (due to the gelatin they contain).
How is the diagnosis made?
First, the clinical symptoms must be compatible with a red meat allergy. Exercise, alcohol and the consumption of painkillers, which can trigger a red meat allergy, should be questioned. It is very important that people with red meat allergies are evaluated by allergy specialists. Along with skin testing, allergy testing is done with red meat allergens and sometimes with fresh meat. With the molecular allergy test, the components causing an allergy to red meat can be revealed in detail. The antibody against the alpha-gal allergen is evaluated.
For those with suspicious red meat allergy test results, a definitive diagnosis is made by performing a provocation test. The results are evaluated with the clinical symptoms and the diagnosis is made.
How is it treated?
Managing food allergies most often involves avoiding red meat. If the patient reacts to raw or undercooked meat, it may be helpful to determine if the meat is well cooked and tolerated, as the patient may retain food in a cooked form in their diet.
Patients with immunoglobulin E (IgE)-mediated meat allergy should be fitted with an epinephrine auto-injector and instructed how and when to use it. The general issues of foodborne anaphylaxis and food allergen avoidance have been reviewed elsewhere.
Few reports of successful desensitization protocols have been published in adults and children allergic to alpha-gal. As alpha-gal allergy appears to improve over time without additional tick bites, it is unclear whether the risks associated with immunological desensitization confer benefit beyond the natural history of the syndrome.
Can a red meat allergy be cured?
Children with cow’s milk allergy who are allergic to beef (representing the largest group of meat-allergic children) tend to outgrow beef and cow’s milk sensitivities. In one study, beef tolerance was reached after a median of three years and preceded cow’s milk tolerance in people with allergies to both foods.
Published data on the natural history of meat allergy in adults are scarce. Case reports show that some people who acquire the allergy as adults lose sensitivity over time.
The natural history of reactions caused by sensitization to galactose-alpha-1,3-galactose (alpha-gal) is not well studied. Although no data from long-term series or controlled studies are available, preliminary evidence from the author’s study suggests that anti-alpha-gal IgE antibodies decline over time in some patients. However, additional tick bites appear to increase antibody levels.
SUMMARY AND RECOMMENDATIONS
●Meat allergy is rare. Exceptions are noted among certain patient groups: children with atopic dermatitis and patients with delayed anaphylaxis in the southeastern United States. The prevalence of allergies to certain meats appears to be related to the importance of a particular meat in the diet. Beef allergy is the most commonly reported.
● Immunoglobulin E (IgE)-mediated and non-mediated forms of meat allergy have been described. IgE-mediated reactions may be delayed immediately after ingestion or up to three to six hours. Non-IgE-mediated disorders involving meat include eosinophilic esophagitis (EE) and pediatric food protein-induced enterocolitis syndrome (FPIES).
●The main meat allergens are serum albumins and immunoglobulins, which change considerably with cooking. This may partly explain why meat allergy is not common. A carbohydrate allergen called galactose-alpha-1,3-galactose (alpha-gal), which appears to be particularly common among patients in the southeastern United States, has also been identified.
● The similarity of different serum albumins may lead to cross-sensitivity between meats and/or allergies to milk and animal dander. Sensitization to alpha-gal may result in cross-sensitivity to gelatins and the monoclonal antibody cetuximab.
● Diagnosis of meat allergy includes history, objective tests, and possibly food load. However, the sensitivity and specificity of meat-specific IgE tests are relatively low. Using fresh meat for skin testing may increase sensitivity.
●Management largely consists of avoiding causative meat and instructing the patient on how to self-inject epinephrine if necessary in the event of accidental exposure.
●Many children and some adults become intolerant to meat over time.