D1.297 - Clinical characteristics of red meat allergy in 19 cases in Jeju

Red meat allergy related to galactose-α-1,3-galactose (α-gal) is an emerging tick-borne food allergy characterized by delayed systemic reactions after ingestion of mammalian meat. Korean data have been limited to small case series. 

Patients diagnosed with red meat allergy at a tertiary hospital in Jeju, Korea, were retrospectively reviewed.

Patients were predominantly middle-aged to older adults, with a slight male predominance (57±14 year-old, male 63.2%). A history of tick bites before symptom onset was documented as certain in a substantial proportion of patients, with additional patients reporting probable exposure, resulting in roughly three-quarters of the cohort having definite or probable tick contact. The leading culprit meats were beef and pork, often accompanied by reactions to other mammalian meats such as dog, goat, roe deer, lamb, or beef intestine, whereas poultry (chicken, duck) and fish were generally tolerated. Urticaria and angioedema were the most common manifestations, and many patients experienced systemic involvement with respiratory and/or gastrointestinal symptoms. Anaphylaxis was frequent, and a majority of patients had at least one ER visit due to red meat–induced reactions, with some requiring multiple visits. In most cases, symptoms developed several hours after meat ingestion, typically within a 3–6-hour window, confirming the characteristic delayed pattern of alpha-gal–mediated allergy. Serum specific IgE to alpha-gal was positive in all tested patients, predominantly in moderate to high ImmunoCAP classes, while poultry-specific IgE was usually negative or low, matching the clinical tolerance profile.

Red meat allergy is an important tick-borne food allergy in Korea and highlight the need for routine α-gal specific IgE testing in patients with unexplained, delayed systemic reactions after red meat ingestion.