A NEWLY reported fatal case of delayed anaphylaxis following beef consumption has drawn renewed attention to alpha-gal syndrome, a tick-associated allergy that is rapidly expanding across the USA. The case shows how severely and silently alpha-gal reactions can unfold hours after eating mammalian meat.
The report describes a 47-year-old man with no known medical issues who experienced two severe overnight reactions after eating beef, the second of which proved fatal. In both episodes, symptoms appeared approximately four hours after the meal, a hallmark pattern of alpha-gal syndrome that often leads to misdiagnosis.
Alpha-Gal Findings Reveal Missed Allergy Risk
Post-mortem testing revealed elevated IgE antibodies to alpha-gal and beef, confirming previously unrecognized sensitisation. Crucially, post-mortem tryptase levels exceeded 2000 ng/mL, a biochemical finding consistent with fatal anaphylaxis.
The circumstances of his first reaction, marked by extreme abdominal pain without rash or breathing problems, illustrate a dangerous challenge: alpha-gal anaphylaxis can involve isolated gastrointestinal symptoms, making it easy for patients and clinicians to overlook the connection to meat ingestion.
Rising Alpha-Gal Allergy Risk Across the USA
Experts emphasise that this case occurs at a time when the Lone Star tick’s range is expanding northward, supported by rising deer populations that serve as key hosts. As a result, the number of people unknowingly sensitised to alpha-gal continues to grow. Yet awareness among clinicians remains low, with recent USA survey data showing many providers are unfamiliar with the condition.
The authors argue that this case underscores the need for greater public and professional education, particularly in areas where the Lone Star tick is emerging. Key messages include recognising delayed reactions, understanding that tick larvae (“chiggers”) can induce sensitisation, and identifying abdominal pain as a potential early sign of anaphylaxis.
Reference
Platts-Mills TAE et al. Implications of a fatal anaphylactic reaction occurring 4 hours after eating beef in a young man with IgE antibodies to galactose-α-1,3-galactose. J Allergy Clin Immunol Pract. 2025; DOI:10.1016/j.jaip.2025.09.017.
