Diagnosis dilemma: Hunter’s rare allergies meant he couldn’t eat red meat anymore

Patient: A 47-year-old man from Michigan

Symptoms: The patient went to the hospital emergency room with swelling eyelids and a rash that was itchy. He told the doctors that these symptoms occurred a day ago, and since their appearance, he felt like he was trying to pass out intermittently. For five days before visiting the hospital, he had been suffering from convulsions, nausea, abdominal pain and vomiting. Three weeks before that, he was developing watery stools after eating.

When doctors at the hospital examined the patients, they found his blood pressure was abnormally low and his heart was beating faster than normal. His lips were swollen, with nest boxes on his scalp, neck, torso and gro diameter. In some places, small hives were integrated into large welts. These are all symptoms of anaphylaxis and severe allergic reactions that can affect swallowing and breathing, doctors wrote in their case report.

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What happened next: During the examination, the patient’s symptoms worsened and he began to develop signs of shock. This is a life-threatening condition in which the organs and tissues of the body do not receive sufficient blood. He administered intravenous fluid, antibiotics, famotidine antacid for excess stomach acid, and steroids to reduce inflammation. The doctor also gave him an injection of epinephrine, also known as adrenaline, to treat his allergic symptoms. (Epinephrine is a substance found in epipen.)

Once the man’s heart rate and blood pressure stabilized within normal range, he was admitted to the hospital’s intensive care unit.

The patient stated that no known allergies other than mild susceptibility to the antibiotic penicillin. His family has no history of allergies and he has recently not eaten food he has never had before. However, the patient had been experiencing days of diarrhea and abdominal pain for weeks prior to the hospital visit, and doctors suspected that his allergic symptoms were caused by newly acquired food allergies. The fact that his symptoms intensified over time suggested that he had repeated exposure to allergens.

After ease, the patient’s symptoms returned to the fourth day at the hospital, including tension, wheezing and shortness of breath in the chest. He received another dose of epinephrine and his symptoms disappeared almost immediately. When the doctor asked the patient, he said he had eaten a spare beef rib about four hours ago. He also recalled eating venison two days before he was admitted to the emergency room.

Diagnosis: Since the mid-2000s, scientists have been aware of a condition called alphagal syndrome, a type of food allergy that is triggered by sugar found in other mammalian products such as gelatin and milk. It is most often caused by the bite of the lonely star tick (amblyomma americanum), but other tick species can also cause it.

The patient reports to be a habitual meat eater and a deer hunter, and the white-tailed deer (Odocoileus virginianus) is a known host of the lonely star tick. The man did not remember being bitten by a tick based on his symptoms and the timing of his appearance, but the doctor concluded that he developed alpha paralysis syndrome after a tick bite after a tick “probably “seed”) several weeks before the symptoms of Alpha Point of View Syndrome.

Initially, his allergic reactions manifested as abdominal distress, and then they strengthened over time as he continued to eat more lean meat.

Treatment: The doctor instructed the patient not to eat lean meat. He was discharged from the hospital and was given steroids to reduce inflammation. He was also given an antihistamine called diphenhydramine, which he uses when needed, as well as an intramuscular epinephrine autosyringe. At a follow-up visit 15 months later, patients refrained from eating meat and reported no more anaphylaxis.

What makes the case unique is meat, a rare food allergen, and many healthcare providers are unfamiliar with Alphagal syndrome, a 2023-reported center for disease control and prevention. Few healthcare providers who know about syndrome are familiar with diagnosing and managing it.

Furthermore, while previously rare in Michigan, the Lonely Star Tick has expanded significantly in recent years. This is mainly due to climate change – mites can live in places that were previously too cold for them – and there are human activities that fragment their habitat and reduce biodiversity. Deer is the preferred host of lonely star mites, and therefore the less diverse ecosystem controlled by deer is more kind to this mites species.

It is not fully understood how mites cause meat allergies, but it is known that pests are likely to produce alphagal antigens and secrete them in saliva. The syndrome is increasingly recognized as a threat to public health around the world, according to the report.