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Allergo Journal International

, Volume 28, Issue 4, pp 103–106 | Cite as

Case series of anaphylactic reactions after rabies vaccinations with gelatin sensitization

  • Fabienne BradfischEmail author
  • Michael Pietsch
  • Stephan Forchhammer
  • Sophia Strobl
  • Henner M. Stege
  • Regina Pietsch
  • Susanne Carstens
  • Knut Schäkel
  • Amir Yazdi
  • Joachim Saloga
original article
  • 38 Downloads

Abstract

Side effects due to allergic reactions to vaccine antigen or to additives such as chicken protein or gelatin have been known for some time. Recent findings regarding reactions mediated via the carbohydrate epitope galactose-alpha-1,3-galactose (alpha-gal), a constituent of animal gelatin, broaden the spectrum of gelatin-related allergies. This case series presents four patients who developed anaphylactic reactions following rabies vaccination using the vaccine Rabipur®. After appropriate allergy testing by skin prick testing and the determination of specific IgE to allergens in the vaccine, triggering by alpha-gal could be excluded and an allergy to gelatin was detected. The absence of allergic symptoms following the consumption of gelatin could potentially be explained through intestinal hydrolysis resulting in a loss of allergenic potency. Further implications related to the use of gelatin-containing infusions in emergency medicine are discussed.

Abbreviations

alpha-gal

Galactose-alpha-1,3-galactose

IgE

Immunoglobulin E

ImmunoCAP

Method to determine the level of specific IgE antibodies

kUa/l

Kilounits of antigen per liter

Notes

Conflict of interest

F. Bradfisch, M. Pietsch, S. Forchhammer, S. Strobl, H.M. Stege, R. Pietsch, S. Carstens, K. Schäkel, A. Yazdi and J. Saloga declare that they have no competing interests.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Fabienne Bradfisch
    • 1
    Email author
  • Michael Pietsch
    • 2
  • Stephan Forchhammer
    • 3
  • Sophia Strobl
    • 4
  • Henner M. Stege
    • 1
  • Regina Pietsch
    • 2
  • Susanne Carstens
    • 2
  • Knut Schäkel
    • 4
  • Amir Yazdi
    • 4
  • Joachim Saloga
    • 1
  1. 1.Department of DermatologyJohannes Gutenberg University HospitalMainzGermany
  2. 2.Department of Hygiene and Infection Prevention (Vaccine Center)Johannes Gutenberg University HospitalMainzGermany
  3. 3.Department of DermatologyUniversity Hospital TübingenTübingenGermany
  4. 4.Department of DermatologyUniversity Hospital HeidelbergHeidelbergGermany

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