exercised two hours before two of the episodes. His past medical history indicated that he had mild hay fever, which he self-treated with over-the-counter antihistamines as needed. He had no cancer, asthma, heart problems, or gastrointestinal problems.
alpha-gal allergy from page 29
over his skin, difficulty breathing, nausea, and vomiting. epinephrine was given immediately, which made his symptoms go away. the fourth episode occurred while he was on a hunting trip in a remote location; he self-injected epinephrine with an epiPen, which relieved the symptoms. an hour later he arrived at a hospital, where his symptoms did not reoccur.
Any food can cause an allergic reaction.
Where? When? the first episode occurred while he was chopping wood during a vacation in Virginia, where he grew up. on two of the four occasions he experienced anaphylaxis, he had eaten fish one to two hours before symptoms appeared. But the other two allergic reactions occurred in the middle of the night, when he had not eaten for six to eight hours.
Medical factors. the patient’s primary care provider tested the patient’s blood to see if the man was allergic to fish. the test was negative. the patient reported that he had not been stung by a bee, wasp, or hornet, which could have explained the anaphylaxis. nor was he taking cancer medication, antibiotics, or blood pressure medication, which also could have caused his reaction. He had taken ibuprofen for knee pain two hours before one of the anaphylactic episodes but had tolerated ibuprofen after the reactions. He had
He said that he had been allergic to ticks when he lived in Virginia but not while living in Minnesota. starting during his teen years in Virginia, he would develop hives around the site of a tick bite and they would itch severely for several days. However, he had never had a tickborne infection, such as lyme disease.
Geography, lifestyle the patient’s lifestyle history revealed that he had recently retired from work as a park ranger. He now was spending more time visiting his relatives in Virginia; while there, he and they often visited a cabin where he had spent a lot of time as a boy. this is where he was when his first anaphylactic episode occurred. Fitting the pieces together the new england Journal of Medicine reported in 2008 that a carbohydrate called galactose-alpha-1,3-galactose (alpha-gal) was causing anaphylaxis in patients who shared several things in common. First, these patients lived in the same part of the country,
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Minnesota HealtH care news December 2013