Meat allergyT78.1

From an allergological point of view meat is considered to be rather harmless. Nevertheless, the importance of meat allergy should not be underestimated in view of increasing meat consumption in Europe. They can be caused by sensitisation to serum albumin. Due to the high cross-reactivity, an IgE determination on a representative serum albumin e.g. Fel d 2(cat) or Bos d 6(cattle) is usually sufficient.

Of all diagnosed food allergies, the proportion of meat allergies is stated to be between 0.5% and 8%. The limited data available must be taken into account. There are hardly any epidemiological studies on larger patient groups. A large part of the available literature consists of casuistics and small case series.

The allergens have not yet been sufficiently characterised. Serum albumin and immunoglobulins are among the most common allergens in chicken, beef and pork and are found in all tissues and secretions. Other known allergens are myoglobin, α-parvalbumin, α-galactose and possibly haemoglobin. S.a. meat allergy of the delayed type.

The symptoms can manifest themselves as food allergy as typical for a type I allergy gastrointestinally, in the upper and lower respiratory tract (rhinitis, laryngeal edema, asthma) and on the skin ( urticaria, angioedema) up to life-threatening anaphylaxis. A single case of a lethal course is described. Meat allergy is of particular importance in the case of occupational exposure to meat (see occupational disease below). On the one hand, frequent cutaneous contact can cause type IV sensitisation in the sense of protein contact dermatitis. On the other hand, generalised symptoms in the sense of a type I allergy can also occur due to the aerogenic spread of allergens when working with raw meat.

• Precise anamnesis, if necessary keeping a diary
• Prick test with commercially available meat solutions, prick-to-prick with native meat (CAVE: Assessment of skin tests with native meat is difficult due to the heat stability of many meat allergens; thus, skin tests often show latent sensitization without clinical relevance).
• Determination of specific IgEs on meat proteins in blood
• Double-blind placebo-controlled oral provocation test with meat (gold standard)

1. Inhibitors W. et al (2011) Meat allergy. Allergology 34: 373-387
2. Worm M et al (2016) Guideline on the management of IgE-mediated food allergies. Allergology 39: 302-344