Galactose-α-1,3-galactose syndrome: An Italian survey

Danilo Villalta, L. Cecchi, A. Farsi, F. Chiarini, P. Minale, S. Voltolini, E. Scala, O. Quercia, L. Muratore, V. Pravettoni, A. M. Calamari, G. Cortellini, R. Asero

Research output: Contribution to journalArticlepeer-review


Background. The term of α-Gal syndrome, which includes the delayed allergy to red meat and the allergic reactions following the administration of cetuximab, is associated to the presence of specific IgE to α-Gal. In Italy, only anecdotal cases were reported so far. The Association of Italian Allergists (AAITO) carried out a survey with the aim of evaluating presence, characteristics, clinical features, and distribution of the syndrome in Italy. Methods. A web structured questionnaire was made available on the website of AAIITO from July 2016 to January 2017. It included 31 multiple-choice questions concerning different items, including the site of physicians, the number of patients diagnosed as having cetuximab allergy and/or delayed red meat allergy, recall of tick bites, symptoms, time to reactions, elicitor foods, reactions with foods other than meat, and in-vivo and in-vitro tests used for the diagnosis. Results. Seventy-nine physicians completed the questionnaire. Nine cases of allergy to cetuximab and 40 cases of delayed red meat allergy were recorded across Italy. 22.5% of patients with cetuximab allergy and 62.5% of those with delayed red meat allergy recalled a tick bite. 75% of patients with delayed red meat allergy experienced symptoms after eating beef (butcher’s cut in 72.5%). Urticaria was the most frequent clinical manifestation (65% of cases). In 60.6% of cases symptoms appeared 2 - 4 hours after meat ingestion, while in 7.9% symptoms appeared after > 4 hours. The most used diagnostic methods were the intradermal test for cetuximab allergy (88.9%) and the detection of IgE to α-Gal (55.5%) for red meat allergy. Most case reports came from Northern Italy. Conclusion. α-Gal syndrome is present in Italy and beef is the most frequent offending food. In most cases symptoms were not severe.

Original languageEnglish
Pages (from-to)263-269
Number of pages7
JournalEuropean Annals of Allergy and Clinical Immunology
Issue number6
Publication statusPublished - Jan 1 2017


  • Cetuximab allergy
  • Red meat allergy
  • Survey
  • α-Gal syndrome

ASJC Scopus subject areas

  • Immunology and Allergy


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