Faculty mentor/PI email address
schachter@rowan.edu
Keywords
alpha-gal syndrome, transient ischemic attack, neurologic symptoms, hypercoagulability, tick-borne allergy, perioperative implications
IRB or IACUC Protocol Number
G26043
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Alpha-gal syndrome (AGS) is an IgE-mediated hypersensitivity reaction to galactose-α-1,3-galactose, typically associated with tick exposure and delayed allergic reactions to mammalian meat products. While most commonly presenting with urticaria, gastrointestinal symptoms, or anaphylaxis, atypical and systemic manifestations remain poorly characterized.
We present the case of a 39-year-old male with minimal vascular risk factors who developed acute onset shortness of breath, chest pressure, and transient neurologic symptoms concerning for a transient ischemic attack. Extensive cardiac, vascular, and autoimmune evaluation was largely unremarkable aside from abnormalities in lupus anticoagulation screening and elevated homocysteine and protein C levels.
Further evaluation revealed elevated alpha-gal–specific IgE levels following a history of recent outdoor exposure. The patient was subsequently diagnosed with alpha-gal syndrome and managed with dietary modification, with no recurrence of symptoms.
This case highlights an atypical presentation in which AGS was identified during evaluation of transient neurologic symptoms. While a causal relationship remains unclear, this case underscores the importance of considering environmental exposures in unexplained presentations. Recognition of AGS also has important perioperative implications, as exposure to mammalian-derived components in medications and surgical materials may increase the risk of allergic reactions.
Disciplines
Digestive System Diseases | Medicine and Health Sciences | Nervous System Diseases
Atypical Presentation of Alpha-Gal Syndrome Identified During Evaluation of Transient Neurologic Symptoms
Alpha-gal syndrome (AGS) is an IgE-mediated hypersensitivity reaction to galactose-α-1,3-galactose, typically associated with tick exposure and delayed allergic reactions to mammalian meat products. While most commonly presenting with urticaria, gastrointestinal symptoms, or anaphylaxis, atypical and systemic manifestations remain poorly characterized.
We present the case of a 39-year-old male with minimal vascular risk factors who developed acute onset shortness of breath, chest pressure, and transient neurologic symptoms concerning for a transient ischemic attack. Extensive cardiac, vascular, and autoimmune evaluation was largely unremarkable aside from abnormalities in lupus anticoagulation screening and elevated homocysteine and protein C levels.
Further evaluation revealed elevated alpha-gal–specific IgE levels following a history of recent outdoor exposure. The patient was subsequently diagnosed with alpha-gal syndrome and managed with dietary modification, with no recurrence of symptoms.
This case highlights an atypical presentation in which AGS was identified during evaluation of transient neurologic symptoms. While a causal relationship remains unclear, this case underscores the importance of considering environmental exposures in unexplained presentations. Recognition of AGS also has important perioperative implications, as exposure to mammalian-derived components in medications and surgical materials may increase the risk of allergic reactions.