Pisazka Veronika, Duscher Georg, Hodžić Adnan, Reider Norbert, Allerberger Franz
Austrian Agency for Health and Food Safety (AGES), Spargelfeldstraße 191, 1220, Vienna, Austria.
Institute of Parasitology, University of Veterinary Medicine Vienna, Vienna, Austria.
Wien Klin Wochenschr. 2019 Aug;131(15-16):385-388. doi: 10.1007/s00508-019-1506-5. Epub 2019 May 13.
Tick bites can cause the alpha-gal syndrome, which is characterized by delayed anaphylactic reactions mainly to red meat and offal due to IgE antibodies against mammalian galactose-alpha-1.3-galactose carbohydrate (alpha-gal). Ixodes ricinus bites are considered the primary cause of IgE antibody responses specific for alpha-gal in Europe. This article reports on a 51-year-old Austrian male who acquired a tick bite in Austria in spring 2017, which, within 48 h, resulted in prolonged inflammation of the skin area around the bite. The patient experienced an allergic reaction 3 months later approximately 8 h after eating a medium rare steak for dinner. The symptoms included an itchy rash on both sides of the torso and on both arms which persisted for several hours. In spring 2018, the patient suffered another tick bite. The patient's skin reaction was similar to that of the previous year. In the following months, the patient experienced five episodes of severe allergic reactions, each during the night after having eaten beef for dinner. The symptoms included pruritic urticarial rash involving the entire body along with swollen hands, diarrhea, vomiting and in some episodes even shortness of breath. At the request of the patient, specific IgE antibodies against alpha-gal were determined, revealing a highly positive result (>100 kU/l). This brief report aims to raise awareness that recurrent delayed anaphylactic reactions to food can develop after tick bites.
蜱虫叮咬可引发α-半乳糖综合征，其特征为主要针对红肉和内脏的迟发性过敏反应，这是由于针对哺乳动物半乳糖-α-1,3-半乳糖碳水化合物（α-半乳糖）的IgE抗体所致。在欧洲，蓖麻蜱叮咬被认为是针对α-半乳糖的IgE抗体反应的主要原因。本文报道了一名51岁的奥地利男性，他于2017年春季在奥地利被蜱虫叮咬，在48小时内，叮咬部位周围的皮肤区域出现了长期炎症。3个月后，患者在晚餐吃了一份三分熟牛排约8小时后出现过敏反应。症状包括躯干两侧和双臂出现瘙痒性皮疹，持续数小时。2018年春季，患者再次被蜱虫叮咬。患者的皮肤反应与前一年相似。在接下来的几个月里，患者经历了五次严重的过敏反应，每次都是在晚餐吃牛肉后的夜间发作。症状包括全身瘙痒性荨麻疹皮疹，伴有手部肿胀、腹泻、呕吐，在某些发作中甚至出现呼吸急促。应患者要求，检测了针对α-半乳糖的特异性IgE抗体，结果呈高度阳性（>100 kU/l）。本简要报告旨在提高人们对蜱虫叮咬后可能发生反复迟发性食物过敏反应的认识。
