PMID- 23569097
OWN - NLM
STAT- MEDLINE
DCOM- 20130717
LR  - 20211021
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Print)
IS  - 0031-4005 (Linking)
VI  - 131
IP  - 5
DP  - 2013 May
TI  - Galactose-alpha-1,3-galactose and delayed anaphylaxis, angioedema, and urticaria in 
      children.
PG  - e1545-52
LID - 10.1542/peds.2012-2585 [doi]
AB  - BACKGROUND AND OBJECTIVE: Despite a thorough history and comprehensive testing, 
      many children who present with recurrent symptoms consistent with allergic 
      reactions elude diagnosis. Recent research has identified a novel cause for 
      "idiopathic" allergic reactions; immunoglobulin E (IgE) antibody specific for the 
      carbohydrate galactose-alpha-1,3-galactose (alpha-Gal) has been associated with delayed 
      urticaria and anaphylaxis that occurs 3 to 6 hours after eating beef, pork, or 
      lamb. We sought to determine whether IgE antibody to alpha-Gal was present in sera of 
      pediatric patients who reported idiopathic anaphylaxis or urticaria. METHODS: 
      Patients aged 4 to 17 were enrolled in an institutional review board-approved 
      protocol at the University of Virginia and private practice allergy offices in 
      Lynchburg, VA. Sera was obtained and analyzed by ImmunoCAP for total IgE and 
      specific IgE to alpha-Gal, beef, pork, cat epithelium and dander, Fel d 1, dog 
      dander, and milk. RESULTS: Forty-five pediatric patients were identified who had 
      both clinical histories supporting delayed anaphylaxis or urticaria to mammalian 
      meat and IgE antibody specific for alpha-Gal. In addition, most of these cases had a 
      history of tick bites within the past year, which itched and persisted. 
      CONCLUSIONS: A novel form of anaphylaxis and urticaria that occurs 3 to 6 hours 
      after eating mammalian meat is not uncommon among children in our area. 
      Identification of these cases may not be straightforward and diagnosis is best 
      confirmed by specific testing, which should certainly be considered for children 
      living in the area where the Lone Star tick is common.
FAU - Kennedy, Joshua L
AU  - Kennedy JL
AD  - Division of Allergy and Immunology, Department of Internal Medicine, University 
      of Virginia Health System, Charlottesville, VA 22908, USA.
FAU - Stallings, Amy P
AU  - Stallings AP
FAU - Platts-Mills, Thomas A E
AU  - Platts-Mills TA
FAU - Oliveira, Walter M
AU  - Oliveira WM
FAU - Workman, Lisa
AU  - Workman L
FAU - James, Haley R
AU  - James HR
FAU - Tripathi, Anubha
AU  - Tripathi A
FAU - Lane, Charles J
AU  - Lane CJ
FAU - Matos, Luis
AU  - Matos L
FAU - Heymann, Peter W
AU  - Heymann PW
FAU - Commins, Scott P
AU  - Commins SP
LA  - eng
GR  - U19-AI-070364/AI/NIAID NIH HHS/United States
GR  - R21 AI087985/AI/NIAID NIH HHS/United States
GR  - T32 AI007496/AI/NIAID NIH HHS/United States
GR  - AI-20565/AI/NIAID NIH HHS/United States
GR  - K08-AI-1085190/AI/NIAID NIH HHS/United States
GR  - K08 AI085190/AI/NIAID NIH HHS/United States
GR  - R21-AI-087985/AI/NIAID NIH HHS/United States
GR  - R37 AI020565/AI/NIAID NIH HHS/United States
GR  - R01 AI020565/AI/NIAID NIH HHS/United States
GR  - U19 AI070364/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20130408
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
RN  - 0 (Allergens)
RN  - 0 (Biomarkers)
RN  - 0 (Disaccharides)
RN  - 13168-24-6 (galactosyl-(1-3)galactose)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adolescent
MH  - Age Distribution
MH  - Allergens/immunology
MH  - Angioedema/epidemiology/immunology
MH  - Animals
MH  - Biomarkers/blood
MH  - Cats
MH  - Cattle
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Disaccharides/*immunology/metabolism
MH  - Dogs
MH  - Female
MH  - Food Hypersensitivity/epidemiology/*etiology/immunology
MH  - Humans
MH  - Hypersensitivity, Delayed/epidemiology/*immunology
MH  - Immunoglobulin E/immunology
MH  - Incidence
MH  - Male
MH  - Meat/*adverse effects
MH  - Prognosis
MH  - Risk Assessment
MH  - Sex Distribution
MH  - Skin Tests
MH  - Statistics, Nonparametric
MH  - Swine
MH  - Time Factors
MH  - Urticaria/epidemiology/*immunology
MH  - Virginia
PMC - PMC3639458
OTO - NOTNLM
OT  - delayed anaphylaxis
OT  - galactose-alpha-1,3-galactose
OT  - pediatric urticaria
OT  - alpha-Gal
EDAT- 2013/04/10 06:00
MHDA- 2013/07/19 06:00
PMCR- 2014/05/01
CRDT- 2013/04/10 06:00
PHST- 2013/04/10 06:00 [entrez]
PHST- 2013/04/10 06:00 [pubmed]
PHST- 2013/07/19 06:00 [medline]
PHST- 2014/05/01 00:00 [pmc-release]
AID - peds.2012-2585 [pii]
AID - 10.1542/peds.2012-2585 [doi]
PST - ppublish
SO  - Pediatrics. 2013 May;131(5):e1545-52. doi: 10.1542/peds.2012-2585. Epub 2013 Apr 
      8.