News In Clinic

Alpha-Gal Meat Allergy is being diagnosed

Recently two of my patients are diagnosed alpha-gal meat allergies. Both are middle aged woman with complaining of abdominal distress and not clear connection to meal consumption (we are eating meat every meal!). One with tick bite history and with skin prurititis. 

What is alpha-gal meat allergy?

Alpha-gal syndrome (AGS), also known as red meat allergy or tick bite meat allergy, is a severe allergic reaction to red meat. Some patients are caused by the bite of certain ticks. When a person with AGS consumes red meat, their immune system mistakenly identifies the alpha-gal sugar molecule found in mammalian meat as a foreign substance, triggering an allergic response. Symptoms of AGS can range from mild, such as hives and itching, to severe, including anaphylaxis, a life-threatening reaction that requires immediate medical attention. 

How are they being diagnosed?

• High suspicion: both patients and doctors need to be educated about this relatively rare condition. Pay attention to the history of tick bite (not necessary), relationship of symptoms to meat/meat related product consumption.

• Blood test: we can check alpha-gal antibodies. 

How are they being treated?

Treatment for AGS involves strict avoidance of red meat and other products (including dairies) containing alpha-gal, as well as carrying an epinephrine auto-injector for potential allergic reactions.

A Novel Mitochondrial Lipodystrophic Syndrome Is Being Diagnosed 

Recently we have a patient who was diagnosed multiple systemic lipomatosis (MSL), MSL is very rare, but our patient is rarer. Our patient has a novel mitochondrial lipodystrophic syndrome.

What is mitochondrial lipodystrophic syndrome?

Patients presented both lipomatous masses and a lipodystrophic syndrome (lipoatrophy, low leptinemia and adiponectinemia, hypertriglyceridemia, insulin resistance and/or diabetes). Charcot-Marie-Tooth neuropathy was of highly variable clinical severity. Lipomatous tissue mainly contained hyperplastic unilocular adipocytes, with few multilocular cells.

Our patient has lipomatosis (fat tumor), lipoatrophy, high triglycerides, insulin resistance and diabetes. She also has severe Charcot-Marie-Tooth neuropathy.

How Do I reach the diagnosis?

I took over the care of a patient from a highly esteemed community diagnostic endocrinologist, who recently retired. This colleague, known for his excellence in the field, entrusted me with some of his more complex cases. Among these, I encountered a patient with a unique condition presenting both lipomatosis (fat tumors) and fat atrophy. Recognizing the need for specialized insight, I connected with a renowned professor at the NIH. This expert generously offered to review her case and arranged for her to be flown to the NIH at no cost to the patient, where she underwent extensive testing.

How will the patient be treated?

In addition to ongoing management of her severe insulin resistance, diabetes, and elevated triglycerides, the NIH professor has proposed to include her in a clinical trial. This presents an opportunity for her to potentially receive groundbreaking treatment. Additionally, she has the chance to receive treatment at the NIH at no cost.