{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:44:45Z","timestamp":1791319485509,"version":"4.3.1"},"reference-count":34,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,5,1]]},"abstract":"\n BACKGROUND AND OBJECTIVE:<\/jats:title>\n Despite a thorough history and comprehensive testing, many children who present with recurrent symptoms consistent with allergic reactions elude diagnosis. Recent research has identified a novel cause for \u201cidiopathic\u201d allergic reactions; immunoglobulin E (IgE) antibody specific for the carbohydrate galactose-\u03b1-1,3-galactose (\u03b1-Gal) has been associated with delayed urticaria and anaphylaxis that occurs 3 to 6 hours after eating beef, pork, or lamb. We sought to determine whether IgE antibody to \u03b1-Gal was present in sera of pediatric patients who reported idiopathic anaphylaxis or urticaria.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n Patients aged 4 to 17 were enrolled in an institutional review board\u2013approved protocol at the University of Virginia and private practice allergy offices in Lynchburg, VA. Sera was obtained and analyzed by ImmunoCAP for total IgE and specific IgE to \u03b1-Gal, beef, pork, cat epithelium and dander, Fel d 1, dog dander, and milk.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n Forty-five pediatric patients were identified who had both clinical histories supporting delayed anaphylaxis or urticaria to mammalian meat and IgE antibody specific for \u03b1-Gal. In addition, most of these cases had a history of tick bites within the past year, which itched and persisted.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n A novel form of anaphylaxis and urticaria that occurs 3 to 6 hours after eating mammalian meat is not uncommon among children in our area. Identification of these cases may not be straightforward and diagnosis is best confirmed by specific testing, which should certainly be considered for children living in the area where the Lone Star tick is common.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2012-2585","type":"journal-article","created":{"date-parts":[[2013,4,8]],"date-time":"2013-04-08T20:47:49Z","timestamp":1365454069000},"page":"e1545-e1552","source":"Crossref","is-referenced-by-count":116,"title":["Galactose-\u03b1-1,3-galactose and Delayed Anaphylaxis, Angioedema, and Urticaria in Children"],"prefix":"10.1542","volume":"131","author":[{"given":"Joshua L.","family":"Kennedy","sequence":"first","affiliation":[{"name":"Division of Allergy and Immunology, Department of Internal Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy P.","family":"Stallings","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Department of Internal Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.E.","family":"Platts-Mills","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Department of Internal Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter M.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Departments of Medical Laboratories and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Workman","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Department of Internal Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haley R.","family":"James","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Department of Internal Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anubha","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Department of Internal Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles J.","family":"Lane","sequence":"additional","affiliation":[{"name":"Allergy Partners of Lynchburg, Lynchburg, Virginia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Matos","sequence":"additional","affiliation":[{"name":"Asthma and Allergy Center of Lynchburg, Lynchburg, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter W.","family":"Heymann","sequence":"additional","affiliation":[{"name":"Pediatrics, University of Virginia Health System, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott P.","family":"Commins","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Department of Internal Medicine and"},{"name":"Pediatrics, University of Virginia Health System, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2013,5,1]]},"reference":[{"issue":"6","key":"2021120900102663000_B1","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1016\/j.jaci.2008.09.043","article-title":"The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project.","volume":"122","author":"Decker","year":"2008","journal-title":"J Allergy Clin Immunol"},{"issue":"4","key":"2021120900102663000_B2","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/0091-6749(76)90194-9","article-title":"Objective clinical and laboratory studies of immediate hypersensitivity reactions to foods in asthmatic children.","volume":"58","author":"May","year":"1976","journal-title":"J Allergy Clin Immunol"},{"issue":"5","key":"2021120900102663000_B3","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/0091-6749(81)90133-0","article-title":"Immunoglobulin E antibodies that crossreact with vegetable foods, pollen, and Hymenoptera venom.","volume":"68","author":"Aalberse","year":"1981","journal-title":"J Allergy Clin Immunol"},{"issue":"4","key":"2021120900102663000_B4","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1159\/000067591","article-title":"IgE to cross-reactive carbohydrate determinants: analysis of the distribution and appraisal of the in vivo and in vitro reactivity.","volume":"129","author":"Mari","year":"2002","journal-title":"Int Arch Allergy Immunol"},{"issue":"1","key":"2021120900102663000_B5","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s11882-009-0079-1","article-title":"Allergenicity of carbohydrates and their role in anaphylactic events.","volume":"10","author":"Commins","year":"2010","journal-title":"Curr Allergy Asthma Rep"},{"issue":"4","key":"2021120900102663000_B6","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.jaci.2009.08.026","article-title":"Anaphylaxis syndromes related to a new mammalian cross-reactive carbohydrate determinant.","volume":"124","author":"Commins","year":"2009","journal-title":"J Allergy Clin Immunol"},{"issue":"2","key":"2021120900102663000_B7","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.jaci.2008.10.052","article-title":"Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-alpha-1,3-galactose.","volume":"123","author":"Commins","year":"2009","journal-title":"J Allergy Clin Immunol"},{"issue":"3","key":"2021120900102663000_B8","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1097\/00007890-199802150-00009","article-title":"Intravenous infusion of Galalpha1-3Gal oligosaccharides in baboons delays hyperacute rejection of porcine heart xenografts.","volume":"65","author":"Simon","year":"1998","journal-title":"Transplantation"},{"issue":"11","key":"2021120900102663000_B9","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1056\/NEJMoa074943","article-title":"Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose.","volume":"358","author":"Chung","year":"2008","journal-title":"N Engl J Med"},{"issue":"15","key":"2021120900102663000_B10","doi-asserted-by":"crossref","first-page":"9858","DOI":"10.1016\/S0021-9258(17)42779-7","article-title":"Occurrence of alpha-D-galactosyl residues in the thyroglobulins from several species. Localization in the saccharide chains of the complex carbohydrate units.","volume":"259","author":"Spiro","year":"1984","journal-title":"J Biol Chem"},{"issue":"2","key":"2021120900102663000_B11","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.bbagen.2007.11.003","article-title":"The Galalpha1,3Galbeta1,4GlcNAc-R (alpha-Gal) epitope: a carbohydrate of unique evolution and clinical relevance.","volume":"1780","author":"Macher","year":"2008","journal-title":"Biochim Biophys Acta"},{"key":"2021120900102663000_B12"},{"issue":"7","key":"2021120900102663000_B13","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1164\/rccm.201111-2017OC","article-title":"Galactose-\u03b1-1,3-galactose-specific IgE is associated with anaphylaxis but not asthma.","volume":"185","author":"Commins","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"issue":"5","key":"2021120900102663000_B14","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/S1081-1206(10)62837-2","article-title":"IgE antibody response to vertebrate meat proteins including tropomyosin.","volume":"83","author":"Ayuso","year":"1999","journal-title":"Ann Allergy Asthma Immunol"},{"issue":"3","key":"2021120900102663000_B15","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1080\/07315724.1995.10718502","article-title":"Meat allergy: I\u2014Specific IgE to BSA and OSA in atopic, beef sensitive children.","volume":"14","author":"Fiocchi","year":"1995","journal-title":"J Am Coll Nutr"},{"issue":"6","key":"2021120900102663000_B16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S1081-1206(10)62114-X","article-title":"Adverse reactions to bovine proteins\u2014then and now.","volume":"89","author":"Fiocchi","year":"2002","journal-title":"Ann Allergy Asthma Immunol"},{"issue":"4","key":"2021120900102663000_B17","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1080\/07315724.1997.10718701","article-title":"Meat allergy: III\u2014Proteins involved and cross-reactivity between different animal species.","volume":"16","author":"Restani","year":"1997","journal-title":"J Am Coll Nutr"},{"issue":"6","key":"2021120900102663000_B18","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/S1081-1206(10)62116-3","article-title":"Cross-reactivity between mammalian proteins.","volume":"89","author":"Restani","year":"2002","journal-title":"Ann Allergy Asthma Immunol"},{"issue":"6","key":"2021120900102663000_B19","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/S1081-1206(10)62121-7","article-title":"Beef allergy in children with cow\u2019s milk allergy; cow\u2019s milk allergy in children with beef allergy.","volume":"89","author":"Martelli","year":"2002","journal-title":"Ann Allergy Asthma Immunol"},{"issue":"3","key":"2021120900102663000_B20","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0091-6749(97)70045-9","article-title":"Clinical reactivity to beef in children allergic to cow\u2019s milk.","volume":"99","author":"Werfel","year":"1997","journal-title":"J Allergy Clin Immunol"},{"issue":"2","key":"2021120900102663000_B21","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.jaci.2004.04.006","article-title":"Viral infections in relation to age, atopy, and season of admission among children hospitalized for wheezing.","volume":"114","author":"Heymann","year":"2004","journal-title":"J Allergy Clin Immunol"},{"issue":"5","key":"2021120900102663000_B22","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/j.jaci.2004.12.1131","article-title":"Quantitative measurement of IgE antibodies to purified allergens using streptavidin linked to a high-capacity solid phase.","volume":"115","author":"Erwin","year":"2005","journal-title":"J Allergy Clin Immunol"},{"issue":"5","key":"2021120900102663000_B23","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1016\/j.jaci.2009.03.011","article-title":"The carbohydrate galactose-alpha-1,3-galactose is a major IgE-binding epitope on cat IgA.","volume":"123","author":"Gr\u00f6nlund","year":"2009","journal-title":"J Allergy Clin Immunol"},{"issue":"4","key":"2021120900102663000_B24","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/MOP.0b013e328305e262","article-title":"An update on childhood urticaria and angioedema.","volume":"20","author":"Bailey","year":"2008","journal-title":"Curr Opin Pediatr"},{"issue":"3","key":"2021120900102663000_B25","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1056\/NEJMcp011186","article-title":"Clinical practice. Chronic urticaria and angioedema.","volume":"346","author":"Kaplan","year":"2002","journal-title":"N Engl J Med"},{"issue":"6","key":"2021120900102663000_B26","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/j.1398-9995.1984.tb01970.x","article-title":"Urticaria in children. Retrospective evaluation and follow-up.","volume":"39","author":"Kauppinen","year":"1984","journal-title":"Allergy"},{"issue":"4","key":"2021120900102663000_B27","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1016\/j.jaci.2007.07.040","article-title":"Trends in hospitalizations for anaphylaxis, angioedema, and urticaria in Australia, 1993-1994 to 2004-2005.","volume":"120","author":"Poulos","year":"2007","journal-title":"J Allergy Clin Immunol"},{"issue":"1","key":"2021120900102663000_B28","first-page":"61","article-title":"Etiologic factors in childhood chronic urticaria.","volume":"69","author":"Volonakis","year":"1992","journal-title":"Ann Allergy"},{"issue":"6","key":"2021120900102663000_B29","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1111\/j.1525-1470.2011.01518.x","article-title":"Evidence-based evaluation and management of chronic urticaria in children.","volume":"28","author":"Zitelli","year":"2011","journal-title":"Pediatr Dermatol"},{"issue":"5","key":"2021120900102663000_B30","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.jaci.2004.03.014","article-title":"Update on food allergy.","volume":"113","author":"Sampson","year":"2004","journal-title":"J Allergy Clin Immunol"},{"issue":"2","key":"2021120900102663000_B31","doi-asserted-by":"crossref","first-page":"S116","DOI":"10.1016\/j.jaci.2009.08.028","article-title":"Food allergy.","volume":"125","author":"Sicherer","year":"2010","journal-title":"J Allergy Clin Immunol"},{"issue":"3","key":"2021120900102663000_B32","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1016\/S0091-6749(96)70111-2","article-title":"Intradermal skin tests in the diagnostic evaluation of food allergy.","volume":"98","author":"Sampson","year":"1996","journal-title":"J Allergy Clin Immunol"},{"issue":"24","key":"2021120900102663000_B33","doi-asserted-by":"crossref","first-page":"3644","DOI":"10.1200\/JCO.2007.11.7812","article-title":"High incidence of cetuximab-related infusion reactions in Tennessee and North Carolina and the association with atopic history.","volume":"25","author":"O\u2019Neil","year":"2007","journal-title":"J Clin Oncol"},{"key":"2021120900102663000_B34","unstructured":"Centers for Disease Control and Prevention. Available at: www.cdc.gov\/ticks\/maps\/lone_star_tick.html. Accessed August 2012"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/131\/5\/e1545\/1090699\/peds_2012-2585.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/131\/5\/e1545\/1090699\/peds_2012-2585.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:41:00Z","timestamp":1639010460000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/131\/5\/e1545\/31281\/Galactose-1-3-galactose-and-Delayed-Anaphylaxis"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,1]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2013,5,1]]},"published-print":{"date-parts":[[2013,5,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2012-2585","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,5,1]]}}}