A retrospective review of α-gal syndrome complicating the management of suspected pancreatic exocrine insufficiency in one gastroenterology clinic in central Virginia
The galactose-α-1,3-galactose (α-gal) mammalian meat allergy, α-gal syndrome, often includes diarrhea, abdominal pain, and other gastrointestinal (GI) symptoms. Pancreatic exocrine insufficiency causes similar symptoms. The pancreatic replacement enzymes, referred to here as pancreatic enzymes, used...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Gastroenterology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fgstr.2023.1162109/full |
| _version_ | 1797772012055166976 |
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| author | Nathan E. Richards Jeffrey M. Wilson Thomas A. E. Platts-Mills Robert D. Richards |
| author_facet | Nathan E. Richards Jeffrey M. Wilson Thomas A. E. Platts-Mills Robert D. Richards |
| author_sort | Nathan E. Richards |
| collection | DOAJ |
| description | The galactose-α-1,3-galactose (α-gal) mammalian meat allergy, α-gal syndrome, often includes diarrhea, abdominal pain, and other gastrointestinal (GI) symptoms. Pancreatic exocrine insufficiency causes similar symptoms. The pancreatic replacement enzymes, referred to here as pancreatic enzymes, used to treat pancreatic insufficiency are porcine products and contain α-gal. Patients with pancreatic insufficiency who also have α-gal syndrome may be intolerant of mammalian products in their diet and of α-gal in pancreatic enzymes. In this article, we describe 40 patients from one GI clinic in central Virginia with suspected pancreatic insufficiency and increased α-gal immunoglobulin E (IgE) levels. Over 50% of these patients had some clinical improvement when mammalian products were removed from the diet. Most patients could tolerate pancreatic enzymes; 10% could not tolerate them due to suspected allergy symptoms, but none developed anaphylaxis. Understanding that α-gal syndrome can be superimposed on pancreatic exocrine insufficiency and exacerbate symptoms, and that treatment with pancreatic enzymes may increase GI and/or allergy symptoms in this group, will lead to improved medical management of this complex patient population. |
| first_indexed | 2024-03-12T21:45:54Z |
| format | Article |
| id | doaj.art-07850f0887344908b6c505da31e7231e |
| institution | Directory Open Access Journal |
| issn | 2813-1169 |
| language | English |
| last_indexed | 2024-03-12T21:45:54Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Gastroenterology |
| spelling | doaj.art-07850f0887344908b6c505da31e7231e2023-07-26T11:59:44ZengFrontiers Media S.A.Frontiers in Gastroenterology2813-11692023-07-01210.3389/fgstr.2023.11621091162109A retrospective review of α-gal syndrome complicating the management of suspected pancreatic exocrine insufficiency in one gastroenterology clinic in central VirginiaNathan E. Richards0Jeffrey M. Wilson1Thomas A. E. Platts-Mills2Robert D. Richards3Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, VA, United StatesDivision of Allergy and Clinical Immunology, University of Virginia, Charlottesville, VA, United StatesDivision of Allergy and Clinical Immunology, University of Virginia, Charlottesville, VA, United StatesGastroenterology Associates of Central Virginia, Lynchburg, VA, United StatesThe galactose-α-1,3-galactose (α-gal) mammalian meat allergy, α-gal syndrome, often includes diarrhea, abdominal pain, and other gastrointestinal (GI) symptoms. Pancreatic exocrine insufficiency causes similar symptoms. The pancreatic replacement enzymes, referred to here as pancreatic enzymes, used to treat pancreatic insufficiency are porcine products and contain α-gal. Patients with pancreatic insufficiency who also have α-gal syndrome may be intolerant of mammalian products in their diet and of α-gal in pancreatic enzymes. In this article, we describe 40 patients from one GI clinic in central Virginia with suspected pancreatic insufficiency and increased α-gal immunoglobulin E (IgE) levels. Over 50% of these patients had some clinical improvement when mammalian products were removed from the diet. Most patients could tolerate pancreatic enzymes; 10% could not tolerate them due to suspected allergy symptoms, but none developed anaphylaxis. Understanding that α-gal syndrome can be superimposed on pancreatic exocrine insufficiency and exacerbate symptoms, and that treatment with pancreatic enzymes may increase GI and/or allergy symptoms in this group, will lead to improved medical management of this complex patient population.https://www.frontiersin.org/articles/10.3389/fgstr.2023.1162109/fullα-galα-gal syndromepancreatic exocrine insufficiencypancreatic enzyme replacementIgEGI-variant α-gal syndrome |
| spellingShingle | Nathan E. Richards Jeffrey M. Wilson Thomas A. E. Platts-Mills Robert D. Richards A retrospective review of α-gal syndrome complicating the management of suspected pancreatic exocrine insufficiency in one gastroenterology clinic in central Virginia Frontiers in Gastroenterology α-gal α-gal syndrome pancreatic exocrine insufficiency pancreatic enzyme replacement IgE GI-variant α-gal syndrome |
| title | A retrospective review of α-gal syndrome complicating the management of suspected pancreatic exocrine insufficiency in one gastroenterology clinic in central Virginia |
| title_full | A retrospective review of α-gal syndrome complicating the management of suspected pancreatic exocrine insufficiency in one gastroenterology clinic in central Virginia |
| title_fullStr | A retrospective review of α-gal syndrome complicating the management of suspected pancreatic exocrine insufficiency in one gastroenterology clinic in central Virginia |
| title_full_unstemmed | A retrospective review of α-gal syndrome complicating the management of suspected pancreatic exocrine insufficiency in one gastroenterology clinic in central Virginia |
| title_short | A retrospective review of α-gal syndrome complicating the management of suspected pancreatic exocrine insufficiency in one gastroenterology clinic in central Virginia |
| title_sort | retrospective review of α gal syndrome complicating the management of suspected pancreatic exocrine insufficiency in one gastroenterology clinic in central virginia |
| topic | α-gal α-gal syndrome pancreatic exocrine insufficiency pancreatic enzyme replacement IgE GI-variant α-gal syndrome |
| url | https://www.frontiersin.org/articles/10.3389/fgstr.2023.1162109/full |
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