Alpha-gal syndrome (mammalian meat allergy)
Alpha-gal syndrome can cause severe allergic reactions. (cdc.gov)
Alpha-gal syndrome includes risk of anaphylaxis, which can progress rapidly and may cause death. (pmc.ncbi.nlm.nih.gov)
Potentially fatal course
Alpha-gal syndrome symptoms can range from mild to severe, and severe reactions can be life-threatening. (cdc.gov)
A subset of alpha-gal allergic patients experiences anaphylaxis. (cghjournal.org)
Acute treatment of suspected anaphylaxis
Immediate intramuscular (IM) epinephrine is first-line treatment for anaphylaxis. (aaaai.org)
Epinephrine should be given IM into the anterolateral thigh (mid-outer thigh). (aaaai.org)
The recommended dose is 0.01 mg/kg of a 1 mg/mL (1:1000) solution with a maximum of 0.5 mg in adults and 0.3 mg in children. (aaaai.org)
If there is an inadequate response, epinephrine dosing should be repeated every 5 to 15 minutes. (aaaai.org)
Adjunctive emergency measures
After epinephrine is administered, additional emergency care should include airway and oxygen support and rapid medical evaluation in an emergency setting. (resus.org.uk)
Antihistamines and corticosteroids can be used as adjunctive therapy, but they should not delay epinephrine administration. (pmc.ncbi.nlm.nih.gov)
Chronic management to prevent reactions
Alpha-gal syndrome management is based on strict avoidance of alpha-gal–containing mammalian products. (gastro.org)
The avoidance diet used in clinical practice eliminates mammalian meat (for example, beef and pork) and other mammalian-derived products. (cghjournal.org)
Patient self-management and emergency preparedness
Patients with suspected alpha-gal allergy should be counseled to ensure access to self-injectable epinephrine. (cghjournal.org)
Patients should have antihistamines available as adjuncts, but epinephrine remains the treatment for worsening or systemic symptoms. (cghjournal.org)
Diagnostic work-up guiding long-term prevention
Diagnosis involves clinical correlation with exposure timing and supported testing for alpha-gal IgE antibodies. (gastro.org)