{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:47:55Z","timestamp":1782388075341,"version":"3.54.5"},"reference-count":8,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alpha\u2010gal syndrome (AGS), an IgE\u2010mediated allergy to galactose\u2010\u03b1\u20101,3\u2010galactose acquired via tick bites, often presents with a delayed gastrointestinal (GI) phenotype without anaphylaxis. We evaluated a local diagnostic guideline in a Far North Queensland gastroenterology outpatient clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective quality assurance audit at Cairns Hospital identified serum\u2010specific IgE (ssIgE) requests to alpha\u2010gal 12 months before and 6 months after guideline implementation (12 March 2025). ImmunoCAP ssIgE\u2009\u2265\u20090.1\u2009kU\/L was positive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 19 patients tested, 5 (26%) were sensitized. All had GI\u2010predominant symptoms\u2014most commonly diarrhea (58%) and abdominal pain (53%)\u2014with no anaphylaxis or respiratory features, and negative preliminary investigations including endoscopy. All three patients completing meat avoidance trials had symptom resolution. Diagnostic yield rose from 2\/16 (12.5%) to 3\/3 (100%) post\u2010guideline, though testing was driven almost exclusively by a single clinician.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The GI phenotype of AGS is present and likely underrecognized in this tick\u2010endemic region. Targeted ssIgE testing after careful clinical assessment yields high diagnostic value, supporting consideration of AGS in unexplained GI symptoms and extending the recognized distribution of the condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgh3.70433","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:12:14Z","timestamp":1781611934000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>MEAT PIES<\/scp>\n                    : Mammalian Meat Allergy in Patients Investigated for Gastrointestinal Symptoms"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5719-2750","authenticated-orcid":false,"given":"Elias","family":"Bitzer","sequence":"first","affiliation":[{"name":"Cairns Hospital, CHHHS  Cairns Queensland Australia"},{"name":"Princes Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bourke","sequence":"additional","affiliation":[{"name":"Clinical Immunology and Allergy Cairns Hospital, CHHHS  Cairns Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shihaz","family":"Hussain","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Cairns Hospital, CHHHS  Cairns Queensland Australia"},{"name":"Gastroenterology and Hepatology Sunshine Coast University Hospital  Sunshine Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"J.Webb J.Davidson andB.Kennedy \u201cCoroners Court of New South Wales \u201d."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2009.08.026"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326\u20105377.2009.tb02533.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.12.035"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.70428"},{"key":"e_1_2_10_7_1","unstructured":"Thermo Fisher Scientific \u201cImmunoCAP Whole Allergen Tests \u201d(2026) https:\/\/www.thermofisher.com\/phadia\/wo\/en\/our\u2010solutions\/immunocap\u2010allergy\u2010solutions\/specific\u2010ige\u2010single\u2010allergens\/whole\u2010allergen.html."},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2020.1782745"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2020.02.190146"}],"container-title":["JGH Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.70433","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jgh3.70433","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.70433","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:05:31Z","timestamp":1782385531000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jgh3.70433"}},"subtitle":["Detection of Mammalian Meat Allergy in the Gastroenterology Outpatient Department, Cairns Hospital, Queensland, Australia"],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":8,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/jgh3.70433"],"URL":"https:\/\/doi.org\/10.1002\/jgh3.70433","archive":["Portico"],"relation":{},"ISSN":["2397-9070","2397-9070"],"issn-type":[{"value":"2397-9070","type":"print"},{"value":"2397-9070","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2026-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70433"}}