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Galactose-α-1,3-galactose and delayed anaphylaxis, angioedema, and urticaria in children.

Publication ,  Journal Article
Kennedy, JL; Stallings, AP; Platts-Mills, TAE; Oliveira, WM; Workman, L; James, HR; Tripathi, A; Lane, CJ; Matos, L; Heymann, PW; Commins, SP
Published in: Pediatrics
May 2013

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-α-1,3-galactose (α-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 α-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 α-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 α-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.

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Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

May 2013

Volume

131

Issue

5

Start / End Page

e1545 / e1552

Location

United States

Related Subject Headings

  • Virginia
  • Urticaria
  • Time Factors
  • Swine
  • Statistics, Nonparametric
  • Skin Tests
  • Sex Distribution
  • Risk Assessment
  • Prognosis
  • Pediatrics
 

Citation

APA
Chicago
ICMJE
MLA
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Kennedy, J. L., Stallings, A. P., Platts-Mills, T. A. E., Oliveira, W. M., Workman, L., James, H. R., … Commins, S. P. (2013). Galactose-α-1,3-galactose and delayed anaphylaxis, angioedema, and urticaria in children. Pediatrics, 131(5), e1545–e1552. https://doi.org/10.1542/peds.2012-2585
Kennedy, Joshua L., Amy P. Stallings, Thomas A. E. Platts-Mills, Walter M. Oliveira, Lisa Workman, Haley R. James, Anubha Tripathi, et al. “Galactose-α-1,3-galactose and delayed anaphylaxis, angioedema, and urticaria in children.Pediatrics 131, no. 5 (May 2013): e1545–52. https://doi.org/10.1542/peds.2012-2585.
Kennedy JL, Stallings AP, Platts-Mills TAE, Oliveira WM, Workman L, James HR, et al. Galactose-α-1,3-galactose and delayed anaphylaxis, angioedema, and urticaria in children. Pediatrics. 2013 May;131(5):e1545–52.
Kennedy, Joshua L., et al. “Galactose-α-1,3-galactose and delayed anaphylaxis, angioedema, and urticaria in children.Pediatrics, vol. 131, no. 5, May 2013, pp. e1545–52. Pubmed, doi:10.1542/peds.2012-2585.
Kennedy JL, Stallings AP, Platts-Mills TAE, Oliveira WM, Workman L, James HR, Tripathi A, Lane CJ, Matos L, Heymann PW, Commins SP. Galactose-α-1,3-galactose and delayed anaphylaxis, angioedema, and urticaria in children. Pediatrics. 2013 May;131(5):e1545–e1552.

Published In

Pediatrics

DOI

EISSN

1098-4275

Publication Date

May 2013

Volume

131

Issue

5

Start / End Page

e1545 / e1552

Location

United States

Related Subject Headings

  • Virginia
  • Urticaria
  • Time Factors
  • Swine
  • Statistics, Nonparametric
  • Skin Tests
  • Sex Distribution
  • Risk Assessment
  • Prognosis
  • Pediatrics