Red Meat Allergies After Lone Star Tick (Amblyomma americanum) Bites

^aArticles not reviewed: tickborne infectious disease and tick paralysis reviews, clinicopathological case conference reports, press releases, perspectives, and opinion-editorial articles.

IgE, immunoglobulin E.
^aCetuximab is a monoclonal antibody cancer chemotherapeutic drug produced in mouse cell lines that can cause anaphylaxis in patients sensitized to α-gal by milk or gelatin allergies or by tick bites.

α-gal, galactose-α-1,3-galactose.

α-gal, galactose-α-1,3-galactose; mAb, monoclonal antibody.

Authors and Disclosures

James H. Diaz, MD, DrPH

School of Public Health, Environmental, and Occupational Health Sciences, Louisiana State University Health Sciences Center, New Orleans.

Correspondence to
Dr James H. Diaz, School of Public Health, Environmental, and Occupational Health Sciences, Louisiana State University Health Sciences Center, 2020 Gravier St, Third Floor, New Orleans, LA 70112. E-mail: jdiaz@lsuhsc.edu.

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Key Points

• The sensitizing antigen to red meat allergy after tick bites is galactose-α-1,3-galactose (α-gal), an oligosaccharide constituent of nonprimate blood and meat, acquired by ticks during animal blood feeding.

• The major risk factors for red meat allergy after tick bites include male sex, non-B blood type, systemic mastocytosis, a bioprosthetic (bovine or porcine) heart valve, and preexisting allergies to gelatin and animal dander.

• In addition to meat avoidance, patients with red meat allergies should avoid gelatin-containing foods and medications and cancer immunotherapy with intravenous cetuximab, a monoclonal antibody produced in mouse cell lines, for life.