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Keywords:

  • immunoblot;
  • meat allergy;
  • skin-prick tests;
  • urticaria

Allergy to meat is very uncommon. It has been described most frequently in children in association with cow's milk and beef allergy (1). Occasional case reports have described acute onset of allergy in adulthood (2).

A 61-year-old female presented with an 18-month history of acute urticarial reactions. All the reactions occurred following the consumption of meat or meat products. She had the most severe reaction after the consumption of a stew containing veal, potatoes and tomatoes. Urticarial reactions developed following consumption of beef, pork, lamb, kangaroo and rabbit. She was able to consume milk, chicken, eggs and fish without any difficulties. Since July 2002, she had avoided all meat products and had no further reactions. However, she was able to consume meat such as prosciutto and other ham products in small quantities. There was no history of atopy. Previously she had experienced an episode of angioedema that was associated with the consumption of aspirin but there was no previous history of reactions to other medications.

Skin-prick tests (SPT) were performed using the fresh food by the prick–prick method and a panel of commercial reagents which included cat, dog, cockroach, house dust mite, cow's milk, egg white, egg yolk, wheat, peanut and soy supplied by Hollister-Stier (Spokane, USA). Specific IgE was measured using Pharmacia CAP RAST (Uppsala, Sweden). Penicillin sensitivity was investigated using the penicilloyl polylysine (PPL) and a minor determinant mixture (MDM) (Allergopen, Reinbek, Germany). SDS-PAGE and immunoblotting were performed according to the method described by Restani et al. (3).

A positive reaction occurred with cat, dog, house dust mite and cow's milk. Skin testing was performed with fresh beef, pork, lamb, kangaroo, rabbit, prosciutto, commercial ham and bovine serum albumin (BSA). Positive reactions were seen with all the meat tests. Skin testing with penicillin reagents was negative. Measurements of specific IgE to beef, pork and lamb were positive. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting were performed with cooked beef, chicken, turkey, horse, pig and kangaroo. The results demonstrated a specific binding of circulating IgEs to a protein having a molecular weight of 81 kDa, and common to beef, horse, pig and kangaroo. A 41-kDa band was also positive for all meat tested. BSA (1, 4) and bovine serum gamma globulin (5) have both been described as clinically relevant allergens in beef. Actin and tropomyosin have also been described but are not considered significant meat allergens (3, 5). On immunoblot, our patient reacted to an 81-kDa protein, which we have not yet fully identified. The patients’ serum also reacted to a 41-kDa band present in all the meats, which corresponds to actin. The significance of binding to actin is unclear. A previous study has demonstrated a high number of positive responses to actin on immunoblot but not confirmed by SPT (3). Actin may be a possible allergen but in polymerized form (the muscular form) does not bind antibodies. Food manufacturing processes may affect the allergenicity of food products through inactivation or destruction of specific epitopes (6). Prosciutto is processed by seasoning and salt curing which may have resulted in a lack of allergenic epitopes in this patient. However, she did develop a wheal to prosciutto on SPT. A unique aspect of this case is the finding of a positive skin test with kangaroo meat, which supports the clinical observation of the development of urticaria following ingestion. This is the first case report of allergy to kangaroo meat. Avoidance of all mammalian meat has resulted in remission of the urticarial reactions.

References

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  2. References
  • 1
    Fiocchi A, Restani P, Riva E, Qualizza R, Bruni P, Restelli AR et al. Meat allergy I: Specific IgE to BSA and OSA in atopic, beef sensitive children. J Am Coll Nutr 1995;14: 239244.
  • 2
    Graham C, Sussman GL, Beezhold DH. Immediate hypersensitivity reaction to venison and beef [Abstract]. J Allergy Clin Immunol 1997;99: S144.
  • 3
    Restani P, Fiocchi A, Beretta B, Velona’ T, Giovannini M, Galli CL. Meat allergy III-Proteins involved and cross-reactivity between different animal species. J Am Coll Nutr 1997;16: 383394.
  • 4
    Werfel SJ, Cooke SK, Sampson HA. Clinical reactivity to beef in children allergic to cows milk. J Allergy Clin Immunol 1997;99: 293300.
  • 5
    Ayuso R, Lehrer SB, Tanaka L, Ibanez MD, Pascual C, Burks AW et al. IgE antibody response to vertebrate meat proteins includes tropomyosin. Ann Allergy Asthma Immunol 1999;83: 399405.
  • 6
    Paschke A, Besler M. Stability of bovine allergens during food processing. Ann Allergy Asthma Immunol 2002;89(Suppl):1620.