Occupational Primary Red Meat Allergy With Sensitization to Serum Albumins, Sus s 1, and Bos d 6

To date, occupational primary red meat allergies have not been reported. A 42-year-old man visited our clinic with allergic symptoms after ingesting red meat. For the past 5 years, he has developed a tingling in the throat and itchy erythema over the whole body immediately after ingesting rare pork and beef, and fresh cream. He had been working at a butcher's shop since he was 22, mainly handling pork and beef. At the age of 26, he noticed wheals appearing on the parts of his body which had been in direct contact with raw meat. At the same time, his atopic dermatitis was worsening. Specific IgE measurements using ImmunoCAP showed positive results for pork, beef, and cow's milk. Skin prick tests showed positive reactions to raw pork and raw beef. In IgE-immunoblotting, one of the two IgE-binding bands to pork and beef was located at 67 kDa, which was consistent with the IgE-binding band to porcine serum albumin, Sus s 1. Furthermore, ImmunoCAP showed positive results for Sus s 1 and the bovine serum albumin, Bos d 6. Poorly controlled atopic dermatitis and occupational skin exposure to red meat likely promoted epicutaneous sensitization, leading to adult-onset primary red meat allergy.