Materiały źródłowe

• #1

  https://www.aaaai.org/allergist-resources/ask-the-expert/answers/2024/clinically

  In order to diagnose clinically significant IgE-mediated allergy to alpha-gal there must be the following: 1) A history of delayed (three to six hours) allergic reactions to mammalian meat. 2) A history of exposure to ticks, often including persistent localized reactions to tick bites. 3) A positive blood test for Galactose-alpha-1,3-galactose (alpha-gal) specific IgE. 4) Responsiveness to dietary changes. […] Given the lack of any symptoms with continued ingestion of mammalian meat and dairy, I would recommend continued avoidance of tick bites and continuing to eat mammalian and dairy as tolerated for now. This may change in the future if the patient’s clinical symptoms change. […] The lack of consistent reactions is, in itself, almost a diagnostic hallmark. […] Over time, patients may experience a „progression” to more consistent reactivity and this likely reflects a new tick bite.

• #1 Diagnosis and Testing – Alpha-gal Information

  https://alphagalinformation.org/diagnosis-and-testing/

  When this website was created, there wasnt an up-to-date, comprehensive guide to the diagnosis and management of alpha-gal syndrome (AGS). Now two have been published, both written by leading experts. […] In 90% of cases, the diagnosis of AGS can be made based on a history of delayed allergic reactions after eating non-primate mammalian meat (e.g. red meat such as beef, pork, or lamb) and a positive blood test (0.1 IU/mL) for IgE to alpha-gal. The combination of both an appropriate clinical history and supporting blood test is necessary to establish an accurate AGS diagnosis (2). […] Doctors diagnose alpha-gal syndrome through a combination of clinical history and tests, including: […] A blood test for Galactose-alpha-1,3-galactose (alpha-gal) specific IgE (sIgE) (1,2) […] With a convincing clinical history, alpha-gal IgE levels at least 0.1 kU/l confirm the diagnosis of alpha-gal syndrome.

• #1 Alpha gal Symptoms, Testing & Treatment Explained – Amy Burkhart, MD, RD

  https://theceliacmd.com/is-your-ibs-due-to-alpha-gal-syndrome/

  Alpha gal syndrome is diagnosed by blood tests and a history of a tick bite correlating with the onset of symptoms. […] The following criteria are currently used for diagnosis: Reactions occur after eating mammalian meat without problems for many years, onset can be at any time. Reactions range from mild to severe and vary person to person. Reactions start 3-8 hours after eating non-primate mammalian meat. Reactions may also occur after consumption of dairy, gelatin, or other mammalian-derived products containing alpha-gal for some patients. Positive testing for alpha-gal IgE (0.1 IU/mL). Improvement of symptoms when adhering to an appropriate avoidance diet. […] It is important to note; there is not yet a defined criterion for what blood levels equate with the diagnosis. In addition, not everyone who tests positive has symptoms.

• #1 Diagnosis and Testing – Alpha-gal Information

  https://alphagalinformation.org/diagnosis-and-testing/

  A blood test for galactose-alpha-1,3-galactose (alpha-gal) specific IgE (sIgE) is the main test that healthcare providers use to help them diagnose alpha-gal syndrome (1,2). […] The final element of diagnosis depends on how they respond clinically to a diet avoiding red meat (1). […] If the antibodies are greater than or equal to 2 IU/mL or more than 2% of the total IgE, this makes the diagnosis very likely. […] The carbohydrate moiety alpha-gal is found in mammalian milk, as evidenced by the positive immunoassay results to cows milk. […] The following characteristics occur in 85% of patients with AGS: […] In terms of diagnosis, skin prick tests with extracts of mammalian meats (beef, pork, or lamb) were shown to be unreliable (2). […] Unfortunately, very often the wrong blood test is performed. […] Parenteral administration of medical products that contain bovine or porcine gelatin is considered even more risky for patients with AGS than consumption of red meat (15).

• #1 Alpha-gal syndrome: Recognizing and managing a tick-bite–related meat allergy | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/92/5/311

  Alpha-gal syndrome is an emerging condition characterized by an immunoglobulin (Ig) E-mediated reaction to galactose-alpha-1,3-galactose (alpha-gal) after consumption of mammalian-derived food products. […] Diagnosis involves a history of consistent symptoms, positive alpha-gal IgE serology, and dietary exclusion trials. […] An alpha-gal IgE level of 0.1 kU/L or greater confirms the diagnosis of alpha-gal syndrome, as it has a reported specificity of 92.3% and a sensitivity of 100%. […] Laboratory testing for IgE antibodies against alpha-gal should be considered when clinical evaluation and patient history confirm 2 or more of the following: Timing: nighttime symptoms, starting with itching; Ticks: history of tick bites, history of avid outdoor activities in tick-prevalent areas, prolonged irritation at the site of the tick bite; Diet: consumes mammalian meats and high-fat dairy.

• #1 Alpha-gal syndrome: How a tick bite can make you allergic to meat | Prevention | UT Southwestern Medical Center

  https://utswmed.org/medblog/meat-allergy-alpha-gal-tick-bite/

  Many people with alpha-gal syndrome go undiagnosed for years because nearly half of health care providers have little or no knowledge of the condition, which has only come into focus in the last decade or so. […] Diagnosis begins with discussing your personal health history, symptoms, and timing of symptoms after eating mammal food products. Well also ask if you remember being bitten by a tick. More than 85% of people with alpha-gal syndrome recall being bitten by a tick. […] A blood test can confirm the diagnosis by measuring the amount of allergic antibodies to alpha-gal in your bloodstream. There is a high false-positive rate to this test, which means it may come back showing you have alpha-gal syndrome when you actually dont. That is one reason it is beneficial to have the test done by an allergist who has experience with alpha-gal syndrome and can accurately interpret the results.

• #1

  https://www.insectshield.com/blogs/blog/tick-bites-red-meat-allergy-and-alpha-gal-syndrome

  The diagnosis of alpha-gal syndrome relies on a combination of clinical history and testing, as testing alone is not sufficient. […] In regions where it is accessible, the primary method of testing is the alpha-gal IgE blood test. […] However, in countries where the alpha-gal IgE blood test is unavailable or in cases where individuals test negative for alpha-gal IgE (known as seronegative cases), alternative options exist. […] If you can imagine having a hamburger for dinner at seven or eight o’clock at night, and then literally nothing happens for four or five or six hours. […] So you’re 100% correct, that the diagnosis can be exceedingly difficult to make. […] Allergy testing by blood work in particular can have a fairly high false positive rate. […] So we really like for there to be some initial symptoms that we feel could be indicative of this allergy.

• #1 Alpha-Gal Syndrome Allergen Facts, Symptoms, and Treatment | Allergy Insider

  https://www.thermofisher.com/allergy/us/en/allergen-fact-sheets/alpha-gal-syndrome.html

  Skin-prick tests with extracts of pork or beef have been unreliable in diagnosing alpha-Gal syndrome. […] Thus, most allergists rely on a blood test for IgE to identify alpha-Gal. Together with your symptom history, specific IgE blood testing can help determine if you are sensitized to a particular allergen. […] If you are diagnosed with an allergy, your healthcare provider will work with you to create a management plan. […] The clinical spectrum of symptoms for alpha-Gal syndrome includes anaphylaxis in up to 60 percent of individuals. […] If you experience a severe allergic reaction, you may need an emergency injection of epinephrine and a visit to the emergency room. Once you’ve been diagnosed with alpha-Gal syndrome, your healthcare provider or allergist likely will prescribe an epinephrine autoinjector.

• #1 Alpha-gal syndrome – Symptoms, diagnosis & treatment – LymeDisease.org

  https://www.lymedisease.org/alpha-gal-syndrome/

  If you experience symptoms after eating mammalian meat products, immediately notify your primary care physician or allergist. […] Your doctor should be able to determine if you have AGS based upon your clinical symptoms and a positive blood test: immunoglobulin E (IgE) to the oligosaccharide glactose-alpha-1,3 galactose (alpha-gal.) […] In the U.S., Viracor is the main laboratory for AGS testing. The Viracor specific IgE galactose-alpha-1,3-galactose test can be taken at most commercial laboratories like Labcorp and Quest and shipped to Viracor. […] Warning: The test for alpha-gal is often mistaken for alpha-galactosidase or a-galactosidase A deficiency—note these are the wrong tests! Because the test is so new, it is recommended to take the proper testing codes with you to the doctor and the laboratory.

• #1 Alpha-Gal Syndrome Test | Alpha-Gal Allergy Test | Quest®

  https://www.questhealth.com/product/alpha-gal-syndrome-allergy-panel-13812M.html?srsltid=AfmBOoqLC1GlZU1LV7VxhnNOstA0HnLmj20pnQbiYK6i12mfWzqt3n1a

  This alpha-Gal blood test measures immunoglobulin E (IgE) antibodies to alpha-Gal and 3 red meat allergens, and may help you and your healthcare provider determine whether you have alpha-Gal Syndrome or a red meat allergy. […] The Alpha-Gal Syndrome Allergy Panel measures immunoglobulin E (IgE) antibodies produced in the blood in response to alpha-Gal and red meat allergens. This alpha-Gal panel measures immune responses to alpha-Gal and 3 meats (beef, lamb, pork) that commonly trigger alpha-Gal-associated meat allergy. […] This test reports the presence of lgE antibodies to alpha-Gal and red meat allergens, but the result by itself cannot confirm the diagnosis of the allergy. It is important to follow up with your healthcare provider. They will review your results along with your medical history, signs and symptoms, medications, and any other test results. Only a healthcare provider can diagnose an allergy and prescribe medication, if needed. […] The results of this test alone should not be used to determine if you have an allergy. It is important to follow up with your healthcare provider. Only a healthcare provider can diagnose or rule out an allergy and help determine next steps.

• #1 Diagnosis and treatment of the alpha-Gal syndrome | JAA

  https://www.dovepress.com/current-and-future-strategies-for-the-diagnosis-and-treatment-of-the-a-peer-reviewed-fulltext-article-JAA

  Diagnostic techniques for this syndrome are not specific and/or represent a risk for the patients health, whereas more precise methods still show limitations to its use. […] SPTs remains a useful diagnostic tool for several food allergies. […] Conversely, conducting this test for AGS diagnosis using conventional and commercially available mammalian meat extracts (beef, pork or lamb) lacks sensitivity, yielding low-reactive results (24 mm wheals), which may lead to misdiagnosis and incorrect patient management. […] For the diagnosis of a food allergy (FA), OFC is the gold standard technique, offering further information regarding food tolerability and threshold of responsiveness. […] Currently, serum anti-Gal IgE levels measured using an immune-enzymatic assay (bovine thyroglobulin-conjugated ImmunoCAP) is the confirmatory diagnostic method used for AGS diagnosis when medical history matches with this disease.

• #1 Alpha-gal syndrome: Recognizing and managing a tick-bite–related meat allergy | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/92/5/311

  Diagnosis can be particularly difficult in patients who have reactions to mammalian products but test negative for alpha-gal IgE, which occurs in approximately 2% of patients referred for evaluation of alpha-gal syndrome. […] Skin prick tests with mammalian meat extracts are unreliable because of false negatives and should not be used to establish an alpha-gal syndrome diagnosis. […] Although food allergies are generally diagnosed through food challenges, the delayed reaction characteristic of alpha-gal syndrome renders such challenges cumbersome and infeasible for routine clinical practice. […] However, if the initial serologic testing does not lead to a clear diagnosis, an oral food challenge may help. […] An oral mammalian meat challenge may be performed with 2 pork sausage patties (70 g) or 3 patties in patients weighing greater than 70 kg.

• #1 Diagnosis and management of patients with the α-Gal syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6980324/

  The -Gal syndrome has many novel features that are relevant to diagnosis and management. In most cases the diagnosis can be made on a history of delayed allergic reactions to red meat and the blood test for IgE to the oligosaccharide galactose-1,3-galactose (-Gal). […] The final element of diagnosis depends on how they respond clinically to a diet avoiding red meat. […] It is important to realize that many cases do not present classically. […] In terms of diagnosis it became clear in early studies that prick tests with extracts of beef or pork were unreliable. […] However, few clinics carry out intradermal tests for food antigens and the majority of allergists rely on a blood test for IgE to -Gal. […] Diagnostically there are two groups that often cause confusion: patients with an unclear history who are found to have IgE to -Gal and secondly patients who give a history of reacting to mammalian products but whose blood test is negative for IgE to -Gal.

• #1 Alpha-Gal Syndrome – What You Need to Know

  https://www.drugs.com/cg/alpha-gal-syndrome.html

  An elimination diet is used to help you avoid anything you may be allergic to for several weeks. If you do not have an allergic reaction, you are exposed to potential allergens one at a time. A provider stays with you to watch for and treat any allergic reactions. When all potential allergens are tested, you will be given a list of any foods or products to avoid.

• #1 Diagnosing Alpha-Gal Syndrome

  http://alphagalsyndrome.blogspot.com/2018/01/diagnosing-alpha-gal-syndrome.html

  The alpha-gal sIgE is somewhat incidental, but the sIgE blood test can still be used to monitor a known case. […] A positive test in someone without symptoms is not predictive of future development of symptoms. […] If someone with recent symptom onset who does not have B+ blood type tests negative in this blood test, then they likely do NOT have alpha-gal syndrome. […] This is a new test being developed that is expected to be more definitive than any of the current diagnostic methods. […] An elimination diet can not only help identify AGS, but can also be used to determine individual tolerance levels. […] In the end, some people have very low tolerance, while others can tolerate all sources of alpha-gal contaminated food with the exception of fatty meats and organs like beef steak and pork kidney. […] While diagnosing alpha-gal syndrome still has a long way to go as far as consistency and assurance of results is concerned, progress is being made on a regular and consistent basis.

• #1 What to know about alpha-gal syndrome | I.M. Matters from ACP

  https://immattersacp.org/archives/2024/01/what-to-know-about-alpha-gal-syndrome.htm

  A key component of alpha-gal syndrome is that the allergic reaction is delayed. Following exposure, patients typically don’t develop an allergic reaction for at least two hours. So, it can be challenging to identify the association between consuming a mammalian product or a medical product that has mammalian products in it and then this delayed allergic reaction a couple hours later. […] When we evaluated health care provider knowledge of alpha-gal syndrome, we found that less than a third of providers knew the correct diagnostic tests to order to confirm alpha-gal syndrome. It’s diagnosed by a combination of clinical history, physical exam, and then serum IgE to alpha-gal. […] We do know that there is typically a prolonged time from onset of symptoms to diagnosis. Previous research suggests that only 21% of patients are diagnosed in their first year of illness and those remaining 79% may take years to be diagnosed.

• #1 10 New and Surprising Facts About Alpha-Gal Syndrome | Allergy Insider

  https://www.thermofisher.com/allergy/us/en/living-with-allergies/food-allergies/10-new-and-surprising-facts-about-alpha-gal-syndrome.html

  While info on alpha-Gal Syndrome is offered by many medical-information sources, such as the Centers for Disease Control and Prevention (CDC), the condition is still relatively unknown. In fact, one study revealed that almost 80 percent of patients with alpha-Gal syndrome struggled to find a diagnosis for more than seven years. […] These stats are particularly troubling because an alpha-Gal IgE simple blood test (along with a medical history and physical exam) can help a healthcare provider diagnose this syndrome. In fact, a single visit with your healthcare provider and a blood draw could help save you not only a boatload of time and money otherwise spent on specialists and unnecessary tests but also a mountain of misery.

• #1

  https://www.nbcnews.com/health/health-news/alpha-gal-syndrome-red-meat-ticks-lone-star-rcna96636

  At least 42% of 1,500 doctors surveyed had never heard of alpha-gal syndrome, a tick-borne illness that can cause potentially life-threatening allergy to red meat. […] Two reports from the Centers for Disease Control and Prevention reveal significant gaps in knowledge about alpha-gal syndrome, even as the condition is rising in the population. […] In one of the new reports, 42% of 1,500 doctors surveyed had never heard of alpha-gal syndrome. A further 35% said they were not confident in their ability to detect or treat the illness. […] If they aren’t thinking of alpha-gal syndrome, a diagnosis can be delayed for years, experts said. […] A second report found that cases of alpha-gal syndrome are rising. From 2017 through 2021, the CDC said, the number of new cases increased by about 15,000 each year.

• #1 CDC alerts clinicians to signs of alpha-gal syndrome | MDedge

  https://mdedge.com/gihepnews/article/264751/ibd-intestinal-disorders/cdc-alerts-clinicians-signs-alpha-gal-syndrome

  The Centers for Disease Control and Prevention has issued a report alerting clinicians to emerging cases of alpha-gal syndrome (AGS) linked with tick bites. […] If alpha-gal is suspected, serum tests for immunoglobulin E (IgE) antibodies should be performed. […] “It is important for gastroenterologists to be aware of this condition and to be capable of diagnosing and treating it in a timely manner,” wrote authors of the clinical practice update in Clinical Gastroenterology and Hepatology. […] The low knowledge is concerning because the range of the lone star tick, which is the species primarily associated with this syndrome, is expanding. […] “Improved health care provider education might facilitate a rapid diagnosis of AGS, improve patient care, and support public health understanding of this emerging condition,” write the report authors, led by Ann Carpenter, DVM, with the CDC.

• #1 What to know about alpha-gal syndrome | I.M. Matters from ACP

  https://immattersacp.org/archives/2024/01/what-to-know-about-alpha-gal-syndrome.htm

  Awareness about alpha-gal syndrome remains low, but the number of suspected cases of people bitten by ticks who develop this allergic reaction has risen sharply since 2010. […] We know from the literature that there’s a delay in diagnosis of patients with alpha-gal syndrome. We found that almost half, or 42%, of those health care providers who we surveyed had never heard of alpha-gal syndrome, and about one-third had little confidence in their ability to diagnose their patients with alpha-gal syndrome. […] Alpha-gal syndrome can be challenging to diagnose. The symptoms can be consistently inconsistent, meaning that some patients can present with only a rash, some with only [gastrointestinal] symptoms, or some with anaphylaxis. Within the same patient, that reaction can be different every time.

• #1

  https://www.aaaai.org/allergist-resources/ask-the-expert/answers/2024/clinically

  Many patients carried a diagnosis of chronic diarrhea, IBS or GI food allergy syndrome prior to AGS diagnosis. […] Overwhelmingly, their symptoms are resolved following diagnosis; oral cromolyn solution can be useful in those patients with lingering GI symptoms. […] Some patients appear to have reactions that require co-factors such that they can tolerate exposures in isolation; consistent with a diagnosis of co-factor dependent-alpha-gal syndrome.

• #1 Diagnosis and management of alpha-gal syndrome – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/diagnosis-and-management-of-alpha-gal-syndrome/

  New guidance helps you identify if unexplained digestive symptoms are due to alpha-gal syndrome, a food allergy caused by lone star tick bites. […] Gastroenterologists should be aware of the diagnosis and management of alpha-gal syndrome because a subset of alpha-gal allergic patients show GI symptoms such as abdominal pain, diarrhea, nausea, or vomiting without skin changes or anaphylaxis. The diagnosis of alpha-gal syndrome can be made among patients with GI distress and increased serum alpha-gal IgE antibodies whose symptoms are relieved adequately on an alpha-gal–avoidance diet that eliminates pork, beef and mammalian-derived products. Patients with suspected alpha-gal allergy should be counseled on an alpha-gal–avoidance diet because that is the primary management. Counseling also should include measures to avoid tick bites because further bites can drive alpha-gal IgE titers higher and worsen the allergy. Patients who also have reactions such as facial swelling, urticaria and respiratory difficulty should be referred to allergists. GI alpha-gal syndrome recently was described and prospective studies are needed to better understand this condition.

• #1 Alpha-Gal Syndrome: An Emerging Food Allergy Related to Tick Bites

  https://www.ccfmed.com/blog/alpha-galsyndrome

  Alpha-gal syndrome (AGS) is a type of allergy to mammalian meat. […] The diagnosis of alpha-gal allergy is based on a clinical history of delayed reactivity to mammalian meat and a blood test that assesses reactivity to galactose-alpha-1-3-galactose. A positive blood test (0.1 IU/mL) for IgE to alpha-gal establishes the diagnosis. […] Notably, skin prick tests for allergies to beef or pork are not reliable for diagnosing AGS. […] Both Quest and LabCorp offer testing for the alpha-gal syndrome. […] Importantly, only 1-8% of individuals sensitized to alpha-gal have clinical alpha-gal syndrome, meaning they neatly fit the clinical diagnostic criteria for AGS. […] This means that many people who test positive for alpha-gal IgE do not exhibit apparent symptoms after eating red meat.

• #1 Diagnosis and treatment of the alpha-Gal syndrome | JAA

  https://www.dovepress.com/current-and-future-strategies-for-the-diagnosis-and-treatment-of-the-a-peer-reviewed-fulltext-article-JAA

  Over the years, research studies allowed to recognize distinct improved biomarkers that provide a more accurate diagnosis of food allergies. […] This led the way to the use of the in vitro functional assay BAT, a flow-cytometry-based technique that quantifies the expression of activation membrane markers, namely, CD63 and CD203c, in order to analyze basophil degranulation when triggered by a specific allergen. […] Another in vitro assay executed by flow cytometry is the MAT, a technique that measures CD63, a membrane activation marker that increases when mast cells (MCs) degranulate. […] Another emerging diagnostic test in the FA field is the HR assay, a standardized test based on fluorescence intensity that measures the amount of histamine released by activated basophils. […] Collective characterization and quantitation of biomolecules known as omics technologies such as metabolomics, metagenomics, proteomics and transcriptomics could advance knowledge of the immune response in AGS and its molecular drivers, enabling the identification of biotargets for molecular diagnosis of this global impact disease. […] Artificial intelligence (AI) and machine learning are considered to be powerful diagnostic assistance tools, which in the future could revolutionize the healthcare system providing an accurate and custom-based diagnosis.

• #1 The Alpha-Gal Syndrome: Unique Tick-Borne Illness on the Rise – Clinical Advisor

  https://www.clinicaladvisor.com/features/alpha-gal-syndrome-tick-borne-illness/

  Alpha-gal syndrome is a rare tick-borne illness that causes a food allergy to red meat in people who are exposed. […] Each year approximately 13,000 to 18,000 people in the United States are diagnosed with AGS; this is likely a low estimate due to widespread lack of recognition and diagnostic testing for AGS. […] Currently, the diagnosis of AGS relies on measuring serum IgE-antibody titers against the alpha-gal carbohydrate, in combination with the patients history of delayed allergic reactions after the ingestion of mammalian food products. […] Medical history is key in the diagnosis of AGS and usually includes a meat-associated delayed allergic reaction and tick bite exposure. […] Skin-prick tests and intradermal testing using meat extracts can be done. However, skin-prick tests yield low reactive results and intradermal testing can trigger anaphylaxis. […] An oral food challenge (OFC) has been described using beef, pork, or lamb. However, there is a risk of anaphylaxis with OFC. […] The basophil activation test (BAT), mast cell activation test (MAT), and histamine release assay are under investigation for AGS.

• #2 What to know about alpha-gal syndrome | I.M. Matters from ACP

  https://immattersacp.org/archives/2024/01/what-to-know-about-alpha-gal-syndrome.htm

  A key component of alpha-gal syndrome is that the allergic reaction is delayed. Following exposure, patients typically don’t develop an allergic reaction for at least two hours. So, it can be challenging to identify the association between consuming a mammalian product or a medical product that has mammalian products in it and then this delayed allergic reaction a couple hours later. […] When we evaluated health care provider knowledge of alpha-gal syndrome, we found that less than a third of providers knew the correct diagnostic tests to order to confirm alpha-gal syndrome. It’s diagnosed by a combination of clinical history, physical exam, and then serum IgE to alpha-gal. […] We do know that there is typically a prolonged time from onset of symptoms to diagnosis. Previous research suggests that only 21% of patients are diagnosed in their first year of illness and those remaining 79% may take years to be diagnosed.

• #2 Diagnosis and management of patients with the α-Gal syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6980324/

  The -Gal syndrome has many novel features that are relevant to diagnosis and management. In most cases the diagnosis can be made on a history of delayed allergic reactions to red meat and the blood test for IgE to the oligosaccharide galactose-1,3-galactose (-Gal). […] The final element of diagnosis depends on how they respond clinically to a diet avoiding red meat. […] It is important to realize that many cases do not present classically. […] In terms of diagnosis it became clear in early studies that prick tests with extracts of beef or pork were unreliable. […] However, few clinics carry out intradermal tests for food antigens and the majority of allergists rely on a blood test for IgE to -Gal. […] Diagnostically there are two groups that often cause confusion: patients with an unclear history who are found to have IgE to -Gal and secondly patients who give a history of reacting to mammalian products but whose blood test is negative for IgE to -Gal.

• #2 Alpha – Gal Syndrome – Primary Care Notebook

  https://primarycarenotebook.com/pages/immunology/alpha-gal-syndrome

  Alpha-gal syndrome (AGS) is an unconventional food allergy, characterized by IgE-mediated hypersensitivity responses to the glycan galactose-alpha-1,3-galactose (alpha-gal) and not to a food-protein […] in 90% of cases the diagnosis of AGS can be made based on a history of delayed allergic reactions after eating non-primate mammalian meat (e.g., „red meat” such as beef, pork, or lamb) and a positive blood test (0.1 IU/mL) for IgE to alpha-gal (2) […] development of alpha-gal IgE is associated with tick bites though the possibility of other parasites promoting sensitization to alpha-gal remains (1).

• #2 650003: Alpha-Gal IgE Panel | Labcorp

  https://www.labcorp.com/tests/650003/alpha-gal-ige-panel

  Measurement of IgE to galactose alpha-1,3-galactose (-Gal sIgE) is used in the differential diagnosis of -Gal mediated allergy. There are two distinct forms of this allergy: the first is an immediate-onset anaphylaxis observed following intravenous infusion of Cetuximab, a monoclonal antibody against epidermal growth factor receptor, and the second is a delayed-onset allergy or anaphylaxis that occurs several hours following consumption of red meat. […] Although the use of component IgE testing may enhance the evaluation of potentially allergic individuals over the use of whole extracts alone, it cannot yet replace clinical history and oral food challenge in most cases. Clinical history, patients age, and presence of comorbidities (such as atopic dermatitis) must be incorporated into the diagnostic determination. […] -Gal IgE levels greater than or equal to 2.0 IU/mL or 2% of the total IgE makes the diagnosis very likely.

• #2 Alpha-gal syndrome – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/alpha-gal-syndrome/

  Doctors can diagnose alpha-gal syndrome using a combination of your personal history and certain medical tests. […] Your doctor will likely start by asking about your exposure to ticks, your signs and symptoms, and how long it took for symptoms to develop after you ate red meat or other mammal products. He or she might also perform a physical exam. […] Additional tests used in the evaluation of alpha-gal syndrome may include: […] A blood test can confirm and measure the amount of alpha-gal antibodies in your bloodstream. This is the key test for diagnosis of alpha-gal syndrome. […] Doctors prick your skin and expose it to small amounts of substances extracted from commercial or fresh red meat. If you’re allergic, you develop a raised bump (hive) at the test site on your skin. Your doctor or allergist may also test your skin for an allergic reaction to individual types of red meat because there are different kinds of allergies to meat.

• #2

  https://www.aaaai.org/allergist-resources/ask-the-expert/answers/2024/clinically

  In order to diagnose clinically significant IgE-mediated allergy to alpha-gal there must be the following: 1) A history of delayed (three to six hours) allergic reactions to mammalian meat. 2) A history of exposure to ticks, often including persistent localized reactions to tick bites. 3) A positive blood test for Galactose-alpha-1,3-galactose (alpha-gal) specific IgE. 4) Responsiveness to dietary changes. […] Given the lack of any symptoms with continued ingestion of mammalian meat and dairy, I would recommend continued avoidance of tick bites and continuing to eat mammalian and dairy as tolerated for now. This may change in the future if the patient’s clinical symptoms change. […] The lack of consistent reactions is, in itself, almost a diagnostic hallmark. […] Over time, patients may experience a „progression” to more consistent reactivity and this likely reflects a new tick bite.

• #2 Alpha-gal Syndrome (AGS) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/alpha-gal-syndrome-ags

  Alpha-gal syndrome (AGS) is an allergic condition in which people are allergic to alpha-gal, a sugar found in the tissues of all mammals except humans and other primates. […] To diagnose AGS, your doctor will review your medical history, conduct a physical exam, and order one or more diagnostic tests. […] To confirm a diagnosis, your doctor may order blood tests to check for the presence of antibodies against alpha-gal and/or against specific types of meat, such as beef or pork. […] While there is no treatment or cure for AGS, treatments are available for the allergic reactions, including anaphylaxis, that people with the condition can experience. […] Your doctor will discuss your history of reactions and monitor blood tests to help determine whether alpha-gal-containing foods can be eaten again.

• #2 Diagnosis and Testing – Alpha-gal Information

  https://alphagalinformation.org/diagnosis-and-testing/

  A blood test for galactose-alpha-1,3-galactose (alpha-gal) specific IgE (sIgE) is the main test that healthcare providers use to help them diagnose alpha-gal syndrome (1,2). […] The final element of diagnosis depends on how they respond clinically to a diet avoiding red meat (1). […] If the antibodies are greater than or equal to 2 IU/mL or more than 2% of the total IgE, this makes the diagnosis very likely. […] The carbohydrate moiety alpha-gal is found in mammalian milk, as evidenced by the positive immunoassay results to cows milk. […] The following characteristics occur in 85% of patients with AGS: […] In terms of diagnosis, skin prick tests with extracts of mammalian meats (beef, pork, or lamb) were shown to be unreliable (2). […] Unfortunately, very often the wrong blood test is performed. […] Parenteral administration of medical products that contain bovine or porcine gelatin is considered even more risky for patients with AGS than consumption of red meat (15).

• #2 Alpha-Gal Panel | Test Detail | Quest Diagnostics

  https://testdirectory.questdiagnostics.com/test/test-detail/10555/alpha-gal-panel?q=10555&cc=MASTER

  Alpha-Gal Panel – This in vitro allergen-specific IgE panel is used to quantitatively measure an individual’s IgE response to alpha-gal, an allergy component, and 3 meats (beef, pork, and lamb) that commonly trigger alpha-gal-associated meat allergy. This IgE panel may be used in conjunction with other clinical information to aid in the diagnosis of alpha-gal syndrome, a severe allergic reaction to mammalian meat induced by past tick bites. […] Most cases of alpha-gal syndrome occur in the southeastern United States because of the heavy presence of the lone star ticks.

• #2 Alpha-Gal Syndrome: An Emerging Food Allergy Related to Tick Bites

  https://www.ccfmed.com/blog/alpha-galsyndrome

  Alpha-gal syndrome (AGS) is a type of allergy to mammalian meat. […] The diagnosis of alpha-gal allergy is based on a clinical history of delayed reactivity to mammalian meat and a blood test that assesses reactivity to galactose-alpha-1-3-galactose. A positive blood test (0.1 IU/mL) for IgE to alpha-gal establishes the diagnosis. […] Notably, skin prick tests for allergies to beef or pork are not reliable for diagnosing AGS. […] Both Quest and LabCorp offer testing for the alpha-gal syndrome. […] Importantly, only 1-8% of individuals sensitized to alpha-gal have clinical alpha-gal syndrome, meaning they neatly fit the clinical diagnostic criteria for AGS. […] This means that many people who test positive for alpha-gal IgE do not exhibit apparent symptoms after eating red meat.

• #2 Diagnosis and treatment of the alpha-Gal syndrome | JAA

  https://www.dovepress.com/current-and-future-strategies-for-the-diagnosis-and-treatment-of-the-a-peer-reviewed-fulltext-article-JAA

  Diagnostic techniques for this syndrome are not specific and/or represent a risk for the patients health, whereas more precise methods still show limitations to its use. […] SPTs remains a useful diagnostic tool for several food allergies. […] Conversely, conducting this test for AGS diagnosis using conventional and commercially available mammalian meat extracts (beef, pork or lamb) lacks sensitivity, yielding low-reactive results (24 mm wheals), which may lead to misdiagnosis and incorrect patient management. […] For the diagnosis of a food allergy (FA), OFC is the gold standard technique, offering further information regarding food tolerability and threshold of responsiveness. […] Currently, serum anti-Gal IgE levels measured using an immune-enzymatic assay (bovine thyroglobulin-conjugated ImmunoCAP) is the confirmatory diagnostic method used for AGS diagnosis when medical history matches with this disease.

• #2 10 New and Surprising Facts About Alpha-Gal Syndrome | Allergy Insider

  https://www.thermofisher.com/allergy/us/en/living-with-allergies/food-allergies/10-new-and-surprising-facts-about-alpha-gal-syndrome.html

  While info on alpha-Gal Syndrome is offered by many medical-information sources, such as the Centers for Disease Control and Prevention (CDC), the condition is still relatively unknown. In fact, one study revealed that almost 80 percent of patients with alpha-Gal syndrome struggled to find a diagnosis for more than seven years. […] These stats are particularly troubling because an alpha-Gal IgE simple blood test (along with a medical history and physical exam) can help a healthcare provider diagnose this syndrome. In fact, a single visit with your healthcare provider and a blood draw could help save you not only a boatload of time and money otherwise spent on specialists and unnecessary tests but also a mountain of misery.

• #2 What to know about alpha-gal syndrome | I.M. Matters from ACP

  https://immattersacp.org/archives/2024/01/what-to-know-about-alpha-gal-syndrome.htm

  Awareness about alpha-gal syndrome remains low, but the number of suspected cases of people bitten by ticks who develop this allergic reaction has risen sharply since 2010. […] We know from the literature that there’s a delay in diagnosis of patients with alpha-gal syndrome. We found that almost half, or 42%, of those health care providers who we surveyed had never heard of alpha-gal syndrome, and about one-third had little confidence in their ability to diagnose their patients with alpha-gal syndrome. […] Alpha-gal syndrome can be challenging to diagnose. The symptoms can be consistently inconsistent, meaning that some patients can present with only a rash, some with only [gastrointestinal] symptoms, or some with anaphylaxis. Within the same patient, that reaction can be different every time.

• #2 CDC alerts clinicians to signs of alpha-gal syndrome | MDedge

  https://mdedge.com/gihepnews/article/264751/ibd-intestinal-disorders/cdc-alerts-clinicians-signs-alpha-gal-syndrome

  An AGS diagnosis “can be made with GI distress and increased serum alpha-gal IgE antibodies whose symptoms are relieved adequately on an alpha-gal avoidance diet that eliminates pork, beef, and mammalian-derived products,” the practice update says. […] Patients whose symptoms also include facial swelling, urticaria, and trouble breathing should be referred to allergists, the AGA update states.

• #2 Diagnosis and Management of Patients with the α-Gal Syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31568928/

  The galactose–1,3-galactose (-Gal) syndrome has many novel features that are relevant to diagnosis and management. In most cases, the diagnosis can be made on a history of delayed allergic reactions to mammalian meat and the blood test for IgE to the oligosaccharide -Gal. […] In general, the diagnosis also dictates the primary treatment, that is, avoiding mammalian meat and also dairy in some cases. […] Blood levels of IgE to -Gal often drop in patients who avoid recurrent tick bites, but the rate of decline is variable. […] Similarly, the delay before reactions is variable and the severity of the allergic reactions is not predicted by the delay or the titer of specific IgE. […] This review focuses on the nature of the syndrome, common challenges in diagnosis and management, and also gaps in our current knowledge that would benefit from additional investigation.

• #2 Alpha gal Symptoms, Testing & Treatment Explained – Amy Burkhart, MD, RD

  https://theceliacmd.com/is-your-ibs-due-to-alpha-gal-syndrome/

  Alpha gal syndrome is diagnosed by blood tests and a history of a tick bite correlating with the onset of symptoms. […] The following criteria are currently used for diagnosis: Reactions occur after eating mammalian meat without problems for many years, onset can be at any time. Reactions range from mild to severe and vary person to person. Reactions start 3-8 hours after eating non-primate mammalian meat. Reactions may also occur after consumption of dairy, gelatin, or other mammalian-derived products containing alpha-gal for some patients. Positive testing for alpha-gal IgE (0.1 IU/mL). Improvement of symptoms when adhering to an appropriate avoidance diet. […] It is important to note; there is not yet a defined criterion for what blood levels equate with the diagnosis. In addition, not everyone who tests positive has symptoms.

• #2 Alpha-Gal Syndrome and Meat Allergy – Allergy & Asthma Network

  https://allergyasthmanetwork.org/food-allergies/alpha-gal-syndrome-and-meat-allergy/

  How is alpha-gal syndrome diagnosed? […] Alpha-gal syndrome can be diagnosed by a board-certified allergist or other healthcare provider trained in the condition. When evaluating you for AGS, the doctor will take a thorough health history; perform a physical exam; order a blood test to check to see if your immune system has developed antibodies to alpha-gal; consider a skin test to determine if other allergies are causing symptoms. […] If the symptoms and testing are consistent with AGS, you will be then given instructions on dietary avoidance. […] AGS is sometimes hard to diagnose because symptoms are often delayed 2-6 hours. […] Talk with your doctor if you think you have alpha-gal syndrome. […] A recent CDC study found that 42% of healthcare providers had not heard of AGS. […] And of those who had heard of AGS, less than a third knew how to diagnose it. […] It’s best to see a board-certified allergist who is trained in diagnosing the condition.

• #2 Unexplained GI Symptoms? Consider Alpha-Gal Syndrome

  https://www.gastroendonews.com/PRN/Article/09-23/Unexplained-GI-Symptoms-Consider-Alpha-Gal-Syndrome/71357

  Our hope is that this [clinical practice update] increases awareness about alpha-gal among gastroenterologists, she said. […] Were hopeful that physicians will keep this diagnosis in their differential when evaluating patients with GI symptoms like abdominal pain, diarrhea, nausea and vomiting and will be more familiar with this condition.

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