{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:44Z","timestamp":1787755604055,"version":"build-2784847793"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 65-year-old woman with alpha-gal syndrome (AGS) required total hip arthroplasty. Laboratories revealed galactose-alpha-1,3-galactose immunoglobulin E 0.4 kU\/L (abnormal \u2265 0.1 kU\/L). In the absence of published guidelines for perioperative management of AGS, we used a pragmatic approach incorporating omalizumab.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Perioperative management of AGS incorporated omalizumab injections, avoidance of high-risk medications and surgical materials containing mammalian derivatives, and pretreatment (corticosteroids, H1 and H2 antihistamines, montelukast). She tolerated hip arthroplasty without perioperative anaphylaxis or AGS symptoms by 4 months of follow-up. High-risk medications include propofol (may contain glycerol), analgesics (gelatin, magnesium stearate, lactose), and heparin (porcine, bovine).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.25.00691","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T19:01:23Z","timestamp":1772737283000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Alpha-Gal Syndrome Managed With Omalizumab for Perioperative Optimization of Total Hip Arthroplasty"],"prefix":"10.2106","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1658-3661","authenticated-orcid":false,"given":"Anita","family":"Kohli-Pamnani","sequence":"first","affiliation":[{"name":"Section of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0328-2578","authenticated-orcid":false,"given":"Mario","family":"Rodenas","sequence":"additional","affiliation":[{"name":"Section of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2299-9287","authenticated-orcid":false,"given":"Bianca Audrey","family":"Duah","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Rehabilitation, Yale-New Haven Hospital, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9249-6100","authenticated-orcid":false,"given":"Jeremy","family":"Ansah-Twum","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Rehabilitation, Yale-New Haven Hospital, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4560-7627","authenticated-orcid":false,"given":"Marcelle","family":"Blessing","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9936-7931","authenticated-orcid":false,"given":"Elie","family":"Mansour","sequence":"additional","affiliation":[{"name":"Hip and Knee Joint Reconstruction Division, Department of Orthopedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1]]},"reference":[{"issue":"7","key":"bib1-20260305","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1080\/1744666X.2020.1782745","article-title":"Diagnosis & management of alpha-gal syndrome: lessons from 2,500 patients","volume":"16","author":"Commins","year":"2020","journal-title":"Expert Rev Clin Immunol."},{"issue":"1","key":"bib2-20260305","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.cgh.2024.06.044","article-title":"Clinical presentation and outcomes of alpha-gal syndrome","volume":"23","author":"Lesmana","year":"2025","journal-title":"Clin Gastroenterol Hepatol."},{"issue":"5","key":"bib3-20260305","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1213\/ANE.0000000000003460","article-title":"What does a red meat allergy have to do with anesthesia? 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