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육고기 알레르기의 임상 양상

Red meat allergy: clinical characteristics

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주제분류소아과학

초록

Purpose: Red meat allergy has recently been described as rare food hypersensitivity with unique pathogenesis and clinical relevance of delayed anaphylaxis. The culprits are various mammal meats containing oligosaccharide epitope (galactose-α-1,3-galactose, α-gal). Interestingly, hard tick bites precede the onset of this allergic condition. The clinical characteristics of red meat allergy had never been reported in Korea. Methods: Among patients diagnosed with food hypersensitivity in a hospital located in Jeju, Korea, those with red meat allergy were recruited. Clinical characteristics were retrospectively reviewed and additionally interviewed. Results: Five patients (mean age, 57±4 years; 4 males and 1 female) were diagnosed as having red meat allergy. They suffered from hives, as the most common symptom, followed by shortness of breath from 10 minutes to 6 hours after exposure to the culprits. Four patients visited the emergency department for anaphylaxis. Culprits included beef, pork, dog, ham, goat, and roe deer. Chicken, duck, bacon, or horse did not cause clinical symptoms. In 4 patients, hard tick bites preceded the onset. Detection of specific IgE to α-gal and culprits such as beef and pork facilitated the confirmative diagnosis. They were advised to avoid mammal meats and to receive a prescription for self-injectable epinephrine. Conclusion: Red meat allergy is one of the food hypersensitivities, characterized by severe and delayed allergic reactions to various meats. Red meat allergy may be a tick-borne illness in Jeju, Korea.

Abstract

Purpose: Red meat allergy has recently been described as rare food hypersensitivity with unique pathogenesis and clinical relevance of delayed anaphylaxis. The culprits are various mammal meats containing oligosaccharide epitope (galactose-α-1,3-galactose, α-gal). Interestingly, hard tick bites precede the onset of this allergic condition. The clinical characteristics of red meat allergy had never been reported in Korea. Methods: Among patients diagnosed with food hypersensitivity in a hospital located in Jeju, Korea, those with red meat allergy were recruited. Clinical characteristics were retrospectively reviewed and additionally interviewed. Results: Five patients (mean age, 57±4 years; 4 males and 1 female) were diagnosed as having red meat allergy. They suffered from hives, as the most common symptom, followed by shortness of breath from 10 minutes to 6 hours after exposure to the culprits. Four patients visited the emergency department for anaphylaxis. Culprits included beef, pork, dog, ham, goat, and roe deer. Chicken, duck, bacon, or horse did not cause clinical symptoms. In 4 patients, hard tick bites preceded the onset. Detection of specific IgE to α-gal and culprits such as beef and pork facilitated the confirmative diagnosis. They were advised to avoid mammal meats and to receive a prescription for self-injectable epinephrine. Conclusion: Red meat allergy is one of the food hypersensitivities, characterized by severe and delayed allergic reactions to various meats. Red meat allergy may be a tick-borne illness in Jeju, Korea.

참고문헌 (13)

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  2. 정경욱, "Age- Based Causes and Clinical Characteristics of Immediate-Type Food Allergy in Korean Children", Allergy, Asthma & Immunology Research, 9(5), pp.423~430 (2017), 대한천식알레르기학회
  3. 이상철, "Clinical Features and Culprit Food Allergens of Korean Adult Food Allergy Patients: A Cross-Sectional Single-Institute Study", Allergy, Asthma & Immunology Research, 11(5), pp.723~735 (2019), 대한천식알레르기학회
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  5. Hamsten C, "Red meat allergy in Sweden : association with tick sensitization and B-negative blood groups", J Allergy Clin Immunol, 132, pp.1431~1434 (2013)
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  7. Simons FE, "2012 Update : World Allergy Organization Guidelines for the assessment and management of anaphylaxis", Curr Opin Allergy Clin Immunol, 12, pp.389~399 (2012)
  8. Chung CH, "Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1, 3-galactose", N Engl J Med, 358, pp.1109~1117 (2008)
  9. Macher BA, "The Galalpha1, 3Galbeta1, 4GlcNAc-R(alpha-Gal)epitope : a carbohydrate of unique evolution and clinical relevance", Biochim Biophys Acta, 1780, pp.75~88 (2008)
  10. Commins SP, "Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-alpha-1, 3-galactose", J Allergy Clin Immunol, 123, pp.426~433 (2009)
  11. Van Nunen SA, "An association between tick bite reactions and red meat allergy in humans", Med J Aust, 190, pp.510~511 (2009)
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  13. 채정병, "Identification of Tick Species Collected from Wild Boars and Habitats of Wild Boars and Domestic Pigs in the Republic of Korea", Parasites, Hosts and Diseases, 55(2), pp.185~191 (2017), 대한기생충학ㆍ열대의학회[DOI]

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