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Galactose-α-1,3-galactose (alpha-gal) syndrome (AGS) is an IgE-mediated allergic reaction to alpha-gal — a carbohydrate found in nonprimate mammalian meat — that is caused by bites from the lone star tick (NEJM JW Gen Med Sep 1 2023 and MMWR Morb Mortal Wkly Rep 2023; 72:809, 815). It easily can be missed, because reactions can be delayed by 4 to 6 hours after eating, and symptoms can vary from person to person. Investigators at the Mayo Clinic in Minnesota performed a chart review of ≈120 patients who tested positive for AGS (out of 1260 who were tested) based on specific IgE levels.
The most common symptoms were urticaria (56%), angioedema (38%), anaphylaxis (36%), diarrhea (32%), nausea (31%), vomiting (23%), abdominal pain (22%), and cra…