ArticleJGH open : an open access journal of gastroenterology and hepatology2026
MEAT PIES: Mammalian Meat Allergy in Patients Investigated for Gastrointestinal Symptoms: Detection of Mammalian Meat Allergy in the Gastroenterology Outpatient Department, Cairns Hospital, Queensland, Australia.
Article in JGH open : an open access journal of gastroenterology and hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Alpha-gal syndrome (AGS), an IgE-mediated allergy to galactose-α-1,3-galactose acquired via tick bites, often presents with a delayed gastrointestinal (GI) phenotype without anaphylaxis. We evaluated a local diagnostic guideline in a Far North Queensland gastroenterology outpatient clinic. Methods: A retrospective quality assurance audit at Cairns Hospital identified serum-specific IgE (ssIgE) requests to alpha-gal 12 months before and 6 months after guideline implementation (12 March 2025). ImmunoCAP ssIgE ≥ 0.1 kU/L was positive. Results: Of 19 patients tested, 5 (26%) were sensitized. All had GI-predominant symptoms-most commonly diarrhea (58%) and abdominal pain (53%)-with no anaphylaxis or respiratory features, and negative preliminary investigations including endoscopy. All three patients completing meat avoidance trials had symptom resolution. Diagnostic yield rose from 2/16 (12.5%) to 3/3 (100%) post-guideline, though testing was driven almost exclusively by a single clinician. Conclusion: The GI phenotype of AGS is present and likely underrecognized in this tick-endemic region. Targeted ssIgE testing after careful clinical assessment yields high diagnostic value, supporting consideration of AGS in unexplained GI symptoms and extending the recognized distribution of the condition.
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