No meat – no sweets? Gelatin-containing sweets can elicit anaphylaxis

Published Online February 26, 2013

A delayed form of anaphylaxis to mammalian meats, with symptom onset  3-6 hours following ingestion, is attributed to  IgE-antibodies recognizing Galactose-α-1,3-galactose (α-Gal). Patients with this form of mammalian meat anaphylaxis may also be at risk from ingestion of meat-derived gelatin, as recent studies suggest that α-Gal may be a relevant allergen in  gelatin.

In a recent issue of The Journal of Allergy and Clinical Immunology: In Practice, Caponetto et al. presented a 58-year-old hunter with delayed-onset mammalian meat anaphylaxis, and elevated IgE antibody to α-Gal, who complained of recurring dizziness, abdominal pain, and diarrhea with delayed onset after ingestion of his favored sweets (a candy with  pork-derived gelatin, HARIBO, Germany). Intracutaneous testing with a 1:100 dilution of Gelafundin 4% (bovine gelatin-derived colloid) was positive. In an oral challenge test the patient consumed 250g of gelatin-containing gums (Haribo), followed by physical exercise  on a bicycle ergometer and 8 hours later, flatulence, abdominal cramps, flushing, tachycardia, and diarrhea occured.

The authors were able to demonstrate that gelatin-containing sweets can elicit type-I-allergic symptoms in Galactose-α-1,3-Galactose-sensitized patients. These findings suggest that the risks of ingesting gelatin-containing foods and using medical gelatin products should be discussed with patients experiencing  anaphylaxis to mammalian meat caused by IgE to α-Gal.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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