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Background Carbohydrate-specific Ig E antibodies present on nonprimate mammalian proteins were incriminated recently in delayed meat anaphylaxis. The aim of this study was to explore whether anaphylaxis to mammalian kidney is also associated with galactose-α-1,3-galactose (α Gal)-specific Ig E. Methods Fourteen patients with anaphylaxis to pork or beef kidney underwent prick tests to meat and kidney. Some patients also underwent skin tests to Erbitux® (cetuximab). Ig E antibodies to α Gal, swine urine proteins, beef and pork meat, serum albumin proteins, cat, and r Fel d 1 were measured by Immuno CAP®. The αGal levels were estimated in meats and kidney by ELISA inhibition assay. Cross-reactivity between α Gal and pork kidney was studied with the Immuno CAP® inhibition assay. Results Among the 14 patients, 12 presented with anaphylactic shock. Reactions occurred within 2 h from exposure in 67% of patients. Associated risk factors were observed in 10 cases, and alcohol was the main cofactor. Three patients underwent an oral challenge to pork kidney, and anaphylaxis occurred after ingestion of small quantities (1-2 g). Prick tests to kidney were positive in 54% of patients. All tested patients showed positive skin tests to Erbitux®. All patients tested positive for Ig E to α Gal, with levels ranging from 0.4 to 294 kU/l. Ig E binding to α Gal was inhibited by raw pork kidney extract (mean, 77%; range, 55-87%), which showed a high amount of α Gal determinants. Conclusions Pork or beef kidney anaphylaxis is related to α Gal Ig E. Its peculiar severity could be due to an elevated content of α Gal epitopes in kidney. [ABSTRACT FROM AUTHOR]

The article presents a case of an 11-month old infant with atopic eczema/dermatitis syndrome (AEDS) and cow's milk allergy. He was fed with an aminoacid formula. The level of contamination is clinically relevant in some milk allergic infants. Ingestion of probiotics with small amount of residual milk proteins may explain sustained AEDS.