Alpha-Gal Syndrome in a Pediatric Patient From Northeast Florida

Alpha-gal syndrome (AGS) is a rare, tick-borne condition that is characterized by a delayed hypersensitivity reaction to galactose-α-1,3-galactose (alpha-gal), a carbohydrate found in mammalian meat products. AGS is increasingly recognized in adults; however, cases often remain underreported or misdiagnosed in children. We report on a 10-year-old male in Northeast Florida presenting with gastrointestinal symptoms, urticaria, and oropharyngeal itching. These symptoms developed hours after consuming a cheeseburger. His medical history revealed multiple previous Lone Star tick bites. After an alpha-gal IgE panel was performed, the elevated specific IgE levels, in addition to the patient's prior history of tick bites, led to a diagnosis of AGS. The patient was prescribed avoidance of mammalian meat and an epinephrine auto-injector. There is a growing need for correct symptom recognition in pediatric cases, and improved clinical recognition may facilitate earlier diagnosis in pediatric patients. Florida's warm climate and abundant wooded and marshy areas support tick activity. Unlike typical IgE-presenting allergens, AGS reactions may occur hours after ingestion, leading to cases remaining underreported or misdiagnosed. Repeated exposures can lead to more severe symptoms, emphasizing the need for early diagnosis. With very limited surveillance, the true prevalence and incidence of AGS in Florida are unknown due to underreporting, and this case report sheds light on the clinical presentation of a pediatric AGS case in Northeast Florida.