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

Area of Science:

• Allergy and Immunology
• Epidemiology
• Tick-borne Diseases

Background:

• Alpha-Gal Syndrome (AGS) involves specific IgE antibodies to alpha-galactose, leading to delayed red meat allergy and cetuximab hypersensitivity.
• Previously, only isolated cases of AGS were documented in Italy.
• A national survey was conducted to assess the prevalence, characteristics, and clinical presentation of AGS in Italy.

Purpose of the Study:

• To evaluate the presence, characteristics, clinical features, and geographical distribution of Alpha-Gal Syndrome in Italy.
• To understand the diagnostic approaches and common triggers associated with AGS within the Italian population.

Main Methods:

• A web-based questionnaire was distributed to physicians via the Association of Italian Allergists (AAITO) from July 2016 to January 2017.
• The survey collected data on diagnosed cases of cetuximab allergy and/or delayed red meat allergy, including tick bite history, symptoms, reaction times, elicitor foods, and diagnostic methods used.

Main Results:

• Seventy-nine physicians responded, reporting 9 cases of cetuximab allergy and 40 cases of delayed red meat allergy.
• A significant percentage of patients with red meat allergy (62.5%) recalled tick bites. Beef was the most frequent trigger (75%), with symptoms often appearing 2-4 hours post-ingestion.
• Urticaria was the most common symptom (65%), and most reactions were not severe. Case reports were predominantly from Northern Italy.

Conclusions:

• Alpha-Gal Syndrome is an emerging health concern in Italy, with delayed red meat allergy being a notable manifestation.
• Beef is the primary food allergen associated with AGS in Italy, and tick bite history is a relevant factor.
• While AGS is present, the majority of reported cases exhibit non-severe clinical symptoms.