{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:51:06Z","timestamp":1787021466399,"version":"build-2736575974"},"reference-count":5,"publisher":"SMC Media","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>The most common cause of vasoplegic shock in critical care is sepsis. However, although rarely and only in specifically sensitised individuals previously bitten by a tick, red meat may provoke a delayed allergic reaction called an alpha-gal syndrome. We present a case of a protracted life-threatening manifestation of alpha-gal syndrome, which, due to an unusual absence of typical features of anaphylaxis can masquerade as septic shock and calls attention to the premature diagnostic closure as a contributor to diagnostic error. Alpha-gal syndrome is a relatively new, but increasingly recognised health issue. We propose that alpha-gal syndrome should be considered in the differential diagnosis of vasoplegic shock of unclear aetiology even in the absence of typical allergic symptomatology and typical allergen exposure since alpha-gal is present in a wide variety of carriers.<\/jats:p>","DOI":"10.12890\/2023_003939","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T03:20:37Z","timestamp":1687231237000},"source":"Crossref","is-referenced-by-count":4,"title":["Alpha-gal syndrome \u2013 A case report of tick-borne anaphylactic shock"],"prefix":"10.12890","volume":"10","author":[{"given":"Jiri","family":"Muller","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine in Pilsen, Pilsen University Hospital, Pilsen, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaroslav Radej","family":"Jaroslav Radej","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine in Pilsen, Pilsen University Hospital, Pilsen, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miroslav Kriz","family":"Miroslav Kriz","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine in Pilsen, Pilsen University Hospital, Pilsen, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliska Hunkova","family":"Eliska Hunkova","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine in Pilsen, Pilsen University Hospital, Pilsen, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Kasparek","family":"Jan Kasparek","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine in Pilsen, Pilsen University Hospital, Pilsen, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin Matejovic","family":"Martin Matejovic","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine in Pilsen, Pilsen University Hospital, Pilsen, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10397","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"key":"10.12890\/2023_003939_ref1","doi-asserted-by":"crossref","unstructured":"<li>Roman Carrasco P, Hemmer W, Cabezas-Cruz A, Hodzic A, de la Fuente J, Swoboda I. The alpha-Gal syndrome and potential mechanisms. <em>Front Allergy<\/em> 2021;<strong>2<\/strong>:783279.<\/li>","DOI":"10.3389\/falgy.2021.783279"},{"key":"10.12890\/2023_003939_ref2","doi-asserted-by":"crossref","unstructured":"<li>Nuttall PA, Labuda M. Tick host interactions: saliva-activated transmission. <em>Parasitology<\/em> 2004;<strong>129<\/strong>:177-189.<\/li>","DOI":"10.1017\/S0031182004005633"},{"key":"10.12890\/2023_003939_ref3","doi-asserted-by":"crossref","unstructured":"<li>Steinke, JW, Platts-Mills, TAE, & Commins, SP The alpha-gal story: lessons learned from connecting the dots. <em>J Allergy Clin Immunol<\/em> 2015;<strong>135<\/strong>:589-596.<\/li>","DOI":"10.1016\/j.jaci.2014.12.1947"},{"key":"10.12890\/2023_003939_ref4","doi-asserted-by":"crossref","unstructured":"<li>Commins SP, Satinover SM, Hosen J, Mozena J, Borish L, Lewis BD, et al. Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-alpha-1,3-galactose. <em>J Allergy Clin Immunol<\/em> 2009;<strong>123<\/strong>:426-433.<\/li>","DOI":"10.1016\/j.jaci.2008.10.052"},{"key":"10.12890\/2023_003939_ref5","doi-asserted-by":"crossref","unstructured":"<li>Platts Mills TAE, Li R-C, Keshavarz B, Smith AR, Wilson JM. Diagnosis and management of patients with the alpha-gal syndrome. <em>J Allergy Clin Immunol Pract<\/em> 2020;<strong>8<\/strong>:15-23.<\/li>","DOI":"10.1016\/j.jaip.2019.09.017"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3939\/3552","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3939\/3553","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3939\/3553","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T09:09:33Z","timestamp":1755680973000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/3939"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,19]]},"references-count":5,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.12890\/2023_003939","relation":{"has-manifestation":[{"id-type":"other","id":"1-102-3939-g3552","asserted-by":"subject"},{"id-type":"other","id":"1-102-3939-g3553","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-102","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"value":"2284-2594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,19]]}}}