Alpha-Gal Syndrome in New England – A Case Report

Introduction: Alpha-gal syndrome (AGS) is an increasingly common allergy to mammalian meats and other mammalian products that is caused by a tick bite from the Lone Star tick. Climate change is likely contributing to expansion of the tick’s range into parts of southern New England. Clinical Findings: The patient was 68 years old at the time of his sensitization. He developed gastrointestinal symptoms, including cramps and diarrhea, approximately 4 to 5 hours after eating a hamburger that he cooked on his home grill. After a second episode a few weeks later, he remembered reading about an allergy to beef and pork caused by tick bites, and he decided to avoid these products. Clinical Course: Avoiding beef and pork products allowed the patient to have no further severe episodes of symptoms. After discussion with a tick researcher and infectious disease specialist, the patient had a serum immunoglobulin E test for alpha-gal, which was positive at 2.5 kUA/L. Over time, the patient learned about other sources of alpha-gal and has been able to continue avoiding symptoms of AGS. Conclusions: Maine clinicians may see cases of AGS as climate change facilitates range expansion of the Lone Star Tick further north along the coast. Clinicians should be alert to new symptoms of meat allergy in adults who were previously able to eat meat. They can use the serum immunoglobulin E level to alpha-gal to confirm suspected cases, and they can recommend avoidance and symptomatic treatment to patients to help with this syndrome.