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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2024; 85(03): e96-e100
DOI: 10.1055/a-2341-7365
Technical Report

Neurosurgical Management of Patients with Alpha-Gal Syndrome

Lucas P. Carlstrom 
1   Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Asad Akhter
1   Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Robert J. Macielak
2   Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Claudio A. Callejas
2   Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Jennifer E. Eickstaedt
3   Department of Clinical Pharmacology, Mayo Clinic, Rochester, Minnesota, United States
,
Christopher Brooks
4   Department of Allergy and Immunology, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Kyle Van Koevering
2   Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Desi Schoo
2   Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Kyle C. Wu
1   Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
,
Daniel M. Prevedello
1   Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
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Abstract

Alpha-gal syndrome (AGS) is an immunoglobulin E–mediated hypersensitivity to galatcose-alpha-1,3-galactose (alpha-gal), a carbohydrate compound present in nonprimate mammalian products. Initial exposure to alpha-gal most often occurs through a tick bite, most commonly the lone star tick in the United States. Repeated exposure to alpha-gal may elicit severe allergic reactions, including anaphylaxis. The allergy restricts dietary intake and may significantly impact perioperative risk, as many medications, anesthetics, and intraoperative surgical products utilize bovine or porcine-derived agents, including those containing magnesium stearate, glycerol, and gelatin. Here, we review the perineurosurgical care of two individuals with AGS and highlight pertinent clinical practices and perioperative management of these patients.

Keywords

alpha-gal syndrome - hemostasis - mammalian products - neurosurgery - anesthesia - gelatin allergy


Publication History

Received: 07 May 2024

Accepted: 05 June 2024

Accepted Manuscript online:
10 June 2024

Article published online:
01 July 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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