Galactose-alpha-1,3-galactose syndrome: an Italian survey

D. Villalta¹ danilo.villalta@aas5.sanita.fvg.it, L. Cecchi², A. Farsi², F. Chiarini², P. Minale³ et al.

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Doi
https://doi.org/10.23822/EurAnnACI.1764-1489.35

Summary
Background. The term of á-Gal syndrome, which includes the delayed allergy to red meat and the allergic reactions following the administration of cetuximab, is associated to the presence of specific IgE to á-Gal. In Italy, only anecdotal cases were reported so far. The Association of Italian Allergists (AAITO) carried out a survey with the aim of evaluating presence, characteristics, clinical features, and distribution of the syndrome in Italy. Methods. A web structured questionnaire was made available on the website of AAIITO from July 2016 to January 2017. It included 31 multiple-choice questions concerning different items, including the site of physicians, the number of patients diagnosed as having cetuximab allergy and/or delayed red meat allergy, recall of tick bites, symptoms, time to reactions, elicitor foods, reactions with foods other than meat, and in-vivo and in-vitro tests used for the diagnosis. Results. Seventy-nine physicians completed the questionnaire. Nine cases of allergy to cetuximab and 40 cases of delayed red meat allergy were recorded across Italy. 22.5% of patients with cetuximab allergy and 62.5% of those with delayed red meat allergy recalled a tick bite. 75% of patients with delayed red meat allergy experienced symptoms after eating beef (butcher's cut in
72.5%). Urticaria was the most frequent clinical manifestation (65% of cases). In 60.6% of cases symptoms appeared 2 - 4 hours after meat ingestion, while in 7.9% symptoms appeared after > 4 hours. The most used diagnostic methods were the intradermal test for cetuximab allergy (88.9%) and the detection of IgE to á-Gal (55.5%) for red meat allergy. Most case reports came from Northern Italy. Conclusion. á-Gal syndrome is present in Italy and beef is the most frequent offending food. In most cases symptoms were not severe.

Key words
á-Gal syndrome; red meat allergy; cetuximab allergy; survey
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