Symptoms, diagnosis and treatment of red meat allergies


diagnosis and treatment of red meat allergy symptoms

If you’re allergic to red meat, don’t let your sacrifice 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 the Allergy and Asthma Association, Prof. Ahmet Akçay gave detailed information on red meat allergy.

What is a meat allergy?

Meat allergy is defined as the onset of fatal reactions such as a drop in blood pressure and fainting, as well as symptoms such as itching, hives, swelling of the lips, 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 to 15 percent of children and 3 percent of adults with food allergies. The low prevalence of meat allergy may be in part 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 frequently reported meat allergy. However, an allergy to beef can reach 20 percent in children allergic to cow’s milk.

Risk factors

The risk factors for developing a meat allergy are not fully defined and may differ depending on which allergen the patient is sensitive to:

● A growing body of evidence suggests that multiple tick bites may be a risk factor for allergy to red meat.

● 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 allergy to cow’s milk may be at increased risk.

● Patients who are allergic to gelatin may also be sensitive to meats or be 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, a red meat allergy is often seen in children with allergies to milk.

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 allergy to milk can also develop a beef allergy at a 20% rate due to cross reactions, as allergenic milk proteins are also present in beef. With good cooking, allergy symptoms may not be visible.

Due to a cat allergy

People with allergies to cats may be allergic to pork due to a cross reaction. People with allergies to pork may be allergic to beef and pork due to a cross reaction. Be careful if you are allergic to cat hair

Related 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 the development of antibodies. As a result, allergy symptoms occur 3-6 hours after consuming red meat.

What are the clinical symptoms?

Immunoglobulin E (IgE) and non-IgE mediated forms of meat allergy have been described. Depending on these forms, the symptoms also differ.

Red meat allergy due to IgE usually develops due to a milk allergy, and red meat allergy symptoms due to cat allergy appear within 2 hours of eating the meat. Symptoms such as hives on the skin, swelling of the lips, and tingling in the mouth mostly occur after eating meat. Symptoms like abdominal pain, vomiting, and diarrhea can also be seen. Sometimes it can cause symptoms of allergic rhinitis and asthma, as well as allergic shock, which is a fatal reaction in the form of a drop in blood pressure and fainting.

Those who are sensitized from 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. In order for beef containing alpha gal to develop an allergy, this allergen has the potential to cause an allergy by binding to lipids or proteins. the Kazanis work. Therefore, the reaction is delayed.

Red meat allergy that is unrelated to IgE may have 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 symptoms of diarrhea are seen 3-4 hours after eating red meat.

cross reaction

Patients with allergy to beef may react to mutton or pork, but rarely to poultry or fish. People with allergies to red meat 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 consistent with a red meat allergy. Exercise, alcohol consumption and pain relievers, which can trigger a red meat allergy, must be questioned. It is very important that people with allergies to red meat are evaluated by allergists. 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. Antibodies to the alpha-gal allergen are evaluated.

For people 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 has a reaction to raw or undercooked meat, it may be helpful to determine whether the meat is well cooked and tolerated, as the patient may retain the food in cooked form in their diet.

Patients with an immunoglobulin E (IgE) mediated allergy to meat should be fitted with an epinephrine auto-injector and be taught how and when to use it. The general problems of foodborne anaphylaxis and avoidance of food allergens have been discussed elsewhere.

Few reports of successful desensitization protocols have been published in adults and children with alpha-gal allergy. As alpha-gal allergy appears to improve over time without additional tick bites, it is not clear whether the risks associated with immunologic desensitization confer benefit beyond the natural history of the syndrome.

Can we cure an allergy to red meat?

Children allergic to cow’s milk who are allergic to beef (representing the largest group of children with allergies to meat) tend to overwhelm sensitivities to beef and cow’s milk. In one study, tolerance to beef was reached after a median of three years and was reported to precede tolerance to cow’s milk in people allergic to both foods.

Published data on the natural history of meat allergy in adults are scarce. Case reports show that some people who contract the allergy in adulthood lose their sensitivity over time.

The natural history of reactions to galactose-alpha-1,3-galactose (alpha-gal) sensitization 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 IgE antibodies to alpha-gal decrease 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 seems to be related to the importance of a particular meat in the diet. Beef allergy is most commonly reported.

● Immunoglobulin E (IgE) mediated and non IgE mediated forms of meat allergy have been described. IgE-mediated reactions may be delayed immediately after ingestion or for up to three to six hours. Non-IgE-mediated disorders involving meats include eosinophilic esophagitis (EE) and pediatric dietary protein enterocolitis syndrome (FPIES).

● The main allergens in meats are serum albumins and immunoglobulins, both of which change significantly 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 in patients in the Southeastern United States, has also been identified.

● The similarity of various serum albumins can cause 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 testing, 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.

● Much of the management consists of avoiding the causative meat and educating 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.


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