Home
HelpTest Code APGAL Galactose-Alpha-1,3-Galactose (Alpha-Gal) Mammalian Meat Allergy Profile, Serum
Ordering Guidance
For a listing of allergens available for testing, see Allergens - Immunoglobulin E (IgE) Antibodies.
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Useful For
As an aid in diagnosis of an IgE mediated hypersensitivity allergy to non-primate mammalian red meat, such as beef, pork, venison, and meat-derived products, such as gelatin, via allergen profile testing
This test is not useful in patients previously treated with immunotherapy to determine if residual clinical sensitivity exists.
This test is not useful for patients in whom the medical management does not depend upon identification of allergen specificity.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ALGAL | Galactose-alpha-1,3-galactose, IgE | Yes | Yes |
| BEEF | Beef, IgE | Yes | Yes |
| PORK | Pork, IgE | Yes | Yes |
| LAMB | Lamb, IgE | Yes | Yes |
| MILK | Milk, IgE | Yes | Yes |
Testing Algorithm
Other meat allergen IgE antibody tests may be considered in addition to galactose-alpha-1,3-galactose IgE antibody testing in cases of suspected red meat allergy.
Special Instructions
Method Name
Fluorescence Enzyme Immunoassay (FEIA)
Reporting Name
Alpha-Gal Panel, SSpecimen Type
SerumSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 90 days |
Reference Values
|
Class |
IgE kU/L |
Interpretation |
|
0 |
<0.10 |
Negative |
|
0/1 |
0.10-0.34 |
Borderline/equivocal |
|
1 |
0.35-0.69 |
Equivocal |
|
2 |
0.70-3.49 |
Positive |
|
3 |
3.50-17.4 |
Positive |
|
4 |
17.5-49.9 |
Strongly positive |
|
5 |
50.0-99.9 |
Strongly positive |
|
6 |
≥100 |
Strongly positive |
Concentrations of 0.70 Ku/L or more (class 2 and above) will flag as abnormally high
Reference values apply to all ages.
Interpretation
Detection of IgE antibodies in serum (class 1 or greater) indicates an increased likelihood of allergic disease as opposed to other etiologies and defines the allergens that may be responsible for eliciting signs and symptoms.
The level of IgE antibodies in serum varies directly with the concentration of IgE antibodies expressed as a class score or kU/L.
Clinical Reference
1. Berg EA, Platts-Mills TAE, Commins SP: Drug allergens and food--the cetuximab and galactose-alpha-1,3-galactose story. Ann Allergy Asthma Immunol. 2014 Feb;112(2):97-101
2. Commins SP, Platts-Mills TAE: Delayed anaphylaxis to red meat in patients with IgE specific for galactose alpha-1,3-galactose (alpha-gal). Curr Allergy Asthma Rep. 2013 Feb;13(1):72-77
3. Commins SP, James HR, Kelly LA, et al: The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-alpha-1,3-galactose. J Allergy Clin Immunol. 2011 May;127(5):1286-1293
4. Wolver SE, Sun DR, Commins SP, Schwartz LB: A peculiar cause of anaphylaxis: no more steak? The journey to discovery of a newly recognized allergy to galactose-alpha-1,3-galactose found in mammalian meat. J Gen Intern Med. 2013 Feb;28(2):322-325
5. Commins SP, Platts-Mills TAE: Tick bites and red meat allergy. Curr Opin Allergy Clin Immunol. 2013 Aug;13(4):354-359
6. Hamsten C, Starkhammar M, Tran TA, et al: Identification of galactose-alpha-1,3-galactose in the gastrointestinal tract of the tick Ixodes ricinus; possible relationship with red meat allergy. Allergy. 2013 Apr;68(4):549-552
7. Steinke JW, Platts-Mills TAE, Commins SP: The alpha-gal story: lessons learned from connecting the dots. J Allergy Clin Immunol. 2015 Mar;135(3):589-597
8. Crispell G, Commins SP, Archer-Hartman SA, Choudhary S, Dharmarajan G, Azadi P, Karim S: Discovery of alpha-gal-containing antigens in North American tick species believed to induce red meat allergy. Front Immunol. 2019 May 17;10:1056
9. Homburger HA, Hamilton RG: Allergic diseases. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. Elsevier; 2017:1057-1070
Day(s) Performed
Monday through Friday
Report Available
Same day/1 to 3 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
86003 x 4
86008
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| APGAL | Alpha-Gal Panel, S | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| BEEF | Beef, IgE | 6039-2 |
| LAMB | Lamb, IgE | 6155-6 |
| MILK | Milk, IgE | 6174-7 |
| PORK | Pork, IgE | 6219-0 |
| ALGAL | Galactose-alpha-1,3-galactose, IgE | 73837-7 |
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Allergen Test Request (T236)
-Microbiology Test Request (T244)