Galactose-alpha-1,3-galactose syndrome: an Italian survey
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Authors Information
Full list of Authors: D. Villalta1, L. Cecchi2, A. Farsi2, F. Chiarini2, P. Minale3, S. Voltolini3, E. Scala4, O. Quercia5, L. Muratore6, V. Pravettoni7, A.M. Calamari8, G. Cortellini9, R. Asero10
1 Immunologia e Allergologia, Ospedale "S. Maria degli Angeli", Pordenone, Italy
2 SOS Allergologia e Immunologia Clinica, USL Toscana Centro, Prato, Italy
3 SOC di Allergologia, IRCCS S. Martino - IST, Genova, Italy
4 Istituto Dermopatico dell'Immacolata - IRCCS, Roma, Italy
5 Unità ad Alta Specializzazione di Allergologia, Ospedale di Faenza, Faenza, Italy
6 Allergy and Clinical Immunology Service, Vito Fazio Hospital, Lecce, Italy
7 UOC Clinical Allergy and Immunology, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
8 Ospedale Castelli, Pallanza, Italy
9 UO di Medicina Interna e Reumatologia, Azienda Sanitaria della Romagna, Rimini, Italy
10 Ambulatorio di Allergologia, Clinica S. Carlo, Paderno Dugnano, Milan, Italy
History
Published online: 2 November 2017
Accepted: 8 September 2017
Received: 26 January 2017
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.
