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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2026; 32(3): 116350
Published online Jan 21, 2026. doi: 10.3748/wjg.v32.i3.116350
Published online Jan 21, 2026. doi: 10.3748/wjg.v32.i3.116350
Misdiagnosis of alpha-gal syndrome as non-celiac gluten sensitivity or lactose intolerance: A diagnostic blind spot for clinicians
Ayoola Awosika, Prithvi Balaji, Department of Family Medicine, University of Illinois College of Medicine Peoria, Bloomington, IL 61601, United States
Author contributions: Awosika A was involved in conceptualization, methodology, synthesis, writing first and review final draft; Balaji P was involved in methodology, synthesis, writing second draft, editing and review final draft.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ayoola Awosika, MD, Department of Family Medicine, University of Illinois College of Medicine Peoria, 1 Illini Drive, Bloomington, IL 61601, United States.
Received: November 10, 2025
Revised: November 18, 2025
Accepted: December 8, 2025
Published online: January 21, 2026
Processing time: 68 Days and 14.6 Hours
Revised: November 18, 2025
Accepted: December 8, 2025
Published online: January 21, 2026
Processing time: 68 Days and 14.6 Hours
Core Tip
Core Tip: Integrating alpha-gal syndrome into the differential diagnosis of unexplained postprandial gastrointestinal symptoms - particularly in individuals from or with travel to tick-endemic areas - is imperative. Awareness of the unique etiologic and immunologic underpinnings of alpha-gal syndrome provides clinicians with a framework to recognize atypical presentations. Concerted efforts are needed to refine diagnostic algorithms, including the judicious use of serum α-gal-specific IgE testing in appropriate clinical contexts, and to develop multidisciplinary pathways linking gastroenterology, allergy/immunology and nutrition.