Misdiagnosis of alpha-gal syndrome as non-celiac gluten sensitivity or lactose intolerance: A diagnostic blind spot for clinicians

Figure 1 Geographic distribution of countries with alpha-gal syndrome cases or IgE sensitization. AGS: Alpha-gal syndrome.

Figure 2 Immune-mediated pathogenesis of alpha-gal syndrome. Exposure of alpha-gal protein to the innate immune system (basophil) results in differentiation of naive T cell into Th2 cell. Eventual IgE production mediates symptom manifestation upon subsequent exposures to mammalian meat. IL: Interleukin.

Figure 3  A simplified algorithm to diagnosing alpha-gal syndrome including alternative differential diagnoses.

Figure 4  Clinical manifestation of alpha-gal syndrome.