Knowing more about this allergy triggered by a tick bite will help physicians both in the US and globally with their differential diagnoses, according to Dr David Johnson.
Hello. I'm Dr David Johnson, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia.The American Gastroenterological Association just releasedBackground on This Emerging Allergy
Surprisingly, the sensitization comes through exposure to a tick bite, and in the United States, the lone star tick has been the most commonly implicated. Reported cases are primarily found in the lone star tick's range from the Midwest to the East, with the only region of relative exclusion being the far Northeast.
Conversely, clinicians should consider not testing those with"red flag" symptoms, particularly people who have anemia, GI bleeding, and weight loss. The allergy doesn't cause these types of symptoms, so you wouldn't seek to diagnostically identify alpha-gal in those situations. This diet should focus on things like mammalian products , and related mammalian-derived products , and be followed for at least a month. And, as we do with our patients with celiac disease, it's very important to caution those with alpha-gal syndrome to avoid eating at restaurants during this time, because they can easily cross-contaminate with food and processed foods, in the form of food additives that otherwise may be missed.
There have been some patients who have reported reactions from just the inhalation of the alpha-gal; for example, from frying bacon or beef products. These may be things to counsel patients about too. There are alpha-gal–free medical device products available, so this is something for those who are performing transplants or vascular surgeons to be aware of, especially if you're practicing in an endemic area and patients may be showing this proclivity.For gastroenterologists following up with patients with alpha-gal syndrome, it's important to recognize that this is a dynamic condition. Symptoms may fluctuate over time.
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