Alpha-gal syndrome: Recognizing and managing a tick-bite-related meat allergy

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. Identified in the early 2000s, the syndrome is linked to sensitization through tick bites; in the United States, the lone star tick (Amblyomma americanum) is the main vector. Symptoms range from pruritus and hives to severe systemic reactions like anaphylaxis, and typically occur 3 to 8 hours after eating meat. Diagnosis involves a history of consistent symptoms, positive alpha-gal IgE serology, and dietary exclusion trials. Management focuses on avoiding foods and products that contain alpha-gal and preventing tick bites.