Red Meat Allergy

A guide to the three dominant forms of red meat allergy

Red meat allergy

Key publications

Red meat allergy
Wilson & Platts-Mills

Features of
three forms of red meat allergy

Skin & specific IgE tests for diagnosis of
red meat allergy

Characteristic test results for
three forms of red meat allergy

Red meat, at least in some populations, is a major food allergen (17).

Wilson JM, Platts-Mills TAE. Red meat allergy in children and adults. Curr Opin Allergy Clin Immunol. 2019;19(3):229-235.

 Red meat allergy

There is more than one mammalian meat allergy. These allergies differ from each other in significant ways. The three dominant forms of mammalian meat allergy are (17):

  • Alpha-gal syndrome: an allergy to the sugar galactose-alpha-1,3-galactose (alpha-gal) in mammalian meat, other parts of mammals, and products derived from them (3)
  • Primary beef allergy (20)
  • Pork-cat syndrome:  an allergy to pork caused by exposure to cats (22, 23)

In addition, up to 20% of children with milk allergy experience reactions after eating beef (19, 21).

Click on the image below to enlarge

Figure 1. Distribution of component-based diagnoses of 261 cases of self-reported mammalian meat allergy. Reproduced with permission from Elsevier.

Source: Wilson JM, Schuyler AJ, Workman L, Gupta M, James HR, Posthumus J, McGowan EC, Commins SP, Platts-Mills TA. Investigation into the α-gal syndrome: characteristics of 261 children and adults reporting red meat allergy. The Journal of Allergy and Clinical Immunology: In Practice. 2019 Sep 1;7(7):2348-58.

Key publications
including UptoDate

Key publications comparing AGS and other mammalian meat allergies

  • Wilson JM, Platts-Mills TA. Red meat allergy in children and adults. Current opinion in allergy and clinical immunology. 2019 Jun 1;19(3):229-35.
  •  Allergy to meats. Commins SP. In: UpToDate, Feldwig, AM (Ed.), UpToDate, Waltham, MA. (online). Updated: Jan 28, 2020. Literature review current through: Oct 2021.

    Highlights from

    Red meat allergy in children and adults

    JM Wilson, MD, PhD; TAE Platts-Mills, MD, PhD

    June, 2019

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    The following are extracts taken directly from this paper:

    Key points

    • ” Red meat, at least in some populations, is a major food allergen.
    • Primary beef allergy, pork-cat syndrome, and a-Gal syndrome represent three distinct forms of red meat allergy with unique clinical and immunologic features.
    • Primary beef allergy is predominantly a disease of young atopic children, pork-cat syndrome is most common in adolescence and early adulthood, and the a-Gal syndrome can present across the lifespan from childhood to old age.
    • There is now good evidence that tick bites are causal in a-Gal sensitization and that the a-Gal syndrome often
      develops in patients without traditional atopy.
    • Specific IgE component testing plays an important role in confirming the presence and form of red
      meat allergy.”

    Features of the three dominant forms of red meat allergy

    adapted from Red meat allergy in children and adults by JM Wilson, MD, PhD; TAE Platts-Mills, MD, PhD

    Click on the image below to enlarge

    Skin and specific IgE tests commonly used in the diagnosis of red meat allergy

    adapted from Red meat allergy in children and adults by JM Wilson, MD, PhD; TAE Platts-Mills, MD, PhD

    Click on the image below to enlarge

    * Intradermal testing using 1:100 dilution of extract used for prick testing (only after obtaining negative results with prick test) is often required in order to see positive skin tests in subjects with α-Gal syndrome.

    Characteristic results from skin and specific IgE tests for the three dominant forms of red meat allergy

    adapted from Red meat allergy in children and adults by JM Wilson, MD, PhD; TAE Platts-Mills, MD, PhD

    Click on the image below to enlarge

    * Typically only positive with intradermal testing