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Frequency of repeating positive alpha gal IgE

Question:

5/11/2017
A patient with alpha-gal allergy. Do you repeat alpha gal IgE and total IgE annually with the hopes of decreasing allergy. At what alpha-gal IgE level would you re-introduce mammalian meat

Answer:

We sought the expert answer from Dr. Scott Commins. His response is below.

"Since AG sIgE does appear to decline over time, I do repeat AG sIgE testing. Typically, my practice is to re-test every 6-8 months but the timing is influenced by the initial sIgE level. For instance, I would re-test a patient with a level over 75 IU/mL at 12 months and not at 6 months because the test is most likely to still be positive at the intermediate time point.
   
In my clinic, we re-introduce dairy before mammalian meat. While the lower AG sIgE appears to indicate a waning allergy, this is not always the case as some patients with low sIgE can be quite sensitive to dietary exposures. Therefore, my clinical practice is guided more by the symptoms of each patient following exposures, both accidental and intentional."

Patricia McNally, MD, FAAAAI