A retrospective evaluation of heparin product reactions in patients with alpha-gal allergies |
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| Institution: | 1. Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States;2. Department of Pharmacy, Sentara Norfolk General Hospital, Norfolk, VA, United States;1. Institute for Hygiene and Applied Immunology; Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria;2. Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria;1. Bacterial Diseases Branch, Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO United States;2. Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States;3. Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States;1. Plataforma de Criação e Experimentação Animal, Fiocruz Rondônia, Fundação Oswaldo Cruz, Porto Velho, RO, Brazil;2. Laboratório de Entomologia, Fiocruz Rondônia, Fundação Oswaldo Cruz, Porto Velho, RO, Brazil;3. Programa de Pós-Graduação em Biologia Parasitária, turma especial de Doutorado em Ciências parceria IOC/Fiocruz Rondônia, Porto Velho, RO, Brazil;4. Bolsista Fundapam / Laboratório de Biologia do Carrapato, Embrapa Gado de Corte, Campo Grande, MS, Brazil;1. Postgraduate Program in Agricultural Microbiology, Universidade Estadual Paulista (FCAV / UNESP), Jaboticabal, SP, Brazil;2. Immunoparasitology Laboratory, Department of Veterinary Pathology, Faculdade de Ciências Agrárias e Veterinárias - Universidade Estadual Paulista (FCAV / UNESP), Jaboticabal, SP, Brazil;1. Programa de Pós-Graduação em Ecologia e Conservação de Recursos Naturais, Universidade Federal de Uberlândia (UFU), Uberlândia, Minas Gerais 38400-902, Brazil;2. Laboratório de Ixodologia, Universidade Federal de Uberlândia (UFU), Brazil;3. Projeto Carnívoros do Iguaçu, Parque Nacional do Iguaçu, BR-469, Km 22.5, Foz do Iguaçu, Paraná 85851-970, Brazil;4. Programa de Pós-graduação em Ecologia e Recursos Naturais, Centro de Ciências, Universidade Federal do Ceará, Campus do PICI, Av. Humberto Monte, Bloco 209. S/N, Fortaleza, Ceará 60455-760, Brazil;5. Instituto Latino-Americano de Ciências da Vida e da Natureza, Universidade Federal da Integração Latino-Americana (UNILA), Foz do Iguaçu, Paraná 85866-970, Brazil;6. Faculdade de Ciências Agrárias e Veterinárias, Departamento de Medicina Veterinária Preventiva e Reprodução Animal, Universidade Estadual Paulista – Unesp, Vias de Acesso Professor Paulo Donato Castellane, S/N, Jaboticabal, São Paulo 14884-900, Brazil |
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| Abstract: | BackgroundAlpha-gal allergy, also known as red meat allergy or alpha-gal syndrome, can present after bites of certain tick species that contain galactose-alpha-1,3-galactose (alpha-gal) carbohydrate. Following this exposure, patients may develop an allergic reaction after mammalian meat consumption. Some heparin products are derived from porcine intestinal tissue, and it is therefore possible that administering these medications to a patient with an alpha-gal allergy may trigger a reaction.ObjectiveThe purpose of this study was to evaluate the incidence of reactions to porcine heparin products in patients with an alpha-gal allergy.MethodsA retrospective case series was conducted by review of electronic medical record data. Patients included were between the ages of 18 and 89 years, with a documented alpha-gal or red meat allergy and an admission to a hospital in the Sentara Healthcare system. The primary outcome was the incidence of allergic reactions upon exposure to heparin products in patients with a documented alpha-gal allergy.ResultsPatients with a documented alpha-gal allergy received a heparin product in 57 of 158 hospital visits (36.1%). Heparin products were tolerated in 56 of the 57 visits (98.3%). The incidence of an alpha-gal reaction to unfractionated heparin was 2.6% (1/39) while the incidence of an alpha-gal reaction to enoxaparin was 0% (0/22).Conclusion and RelevanceHeparin products were associated with a low incidence of alpha-gal reactions among patients with documented alpha-gal allergy. It is possible that enoxaparin poses less of a risk for reaction in these patients compared to unfractionated heparin. |
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