Clinical reactivity to beef in children allergic to cow's milk

J Allergy Clin Immunol. 1997 Mar;99(3):293-300. doi: 10.1016/s0091-6749(97)70045-9.


Background: Cow's milk is one of the most common food allergens in children. Limited information is available on the prevalence of reactivity to a related food source, beef. The purposes of this study were to examine the prevalence of symptomatic sensitivity to beef in a selected pediatric population and to determine the frequency of concomitant reactivity to cow's milk and beef.

Methods: Children referred for assessment of atopic dermatitis and possible food hypersensitivity were evaluated for symptomatic reactivity to beef by double-blind placebo-controlled food challenges (DBPCFCs) and subsequent open feedings of beef. Sodium dodecyl-sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), immunoblot, and immunodot blot analyses were performed with patients' sera on preparations of beef extracts subjected to different cooking conditions: raw (no heating), medium, and well-cooked.

Results: Eleven of 335 children referred for evaluation of atopic dermatitis and possible food hypersensitivity were found to have symptomatic sensitivity to beef; eight were also sensitive to milk, as demonstrated in previous DBPCFCs. Eight patients reacted to beef during DBPCFC, and three tolerated beef in a DBPCFC and well-cooked beef in an open challenge but reacted to ingestion of less well-cooked beef. SDS-PAGE of raw beef revealed at least 24 protein fractions. Several protein bands in raw beef appeared to denature with heating. Bovine serum albumin and bovine gamma globulin were heat-labile in the beef extract, but six protein fractions persisted even after heating the beef extract for 2 hours at 85 degrees C. IgE from patients reacting to rare and well-cooked beef bound up to six of these heat-resistant fractions, but IgE from patients reacting only to rare beef failed to bind any of these fractions with one exception. In addition, patients reacting to rare and well-cooked beef had specific IgE to a 17.8 kd fraction, which was only weakly recognized by one patient reacting only to rare beef.

Conclusions: Specific IgE antibodies to heat-labile beef proteins might explain why some patients can tolerate well-cooked beef but not medium-rare and rare beef. Patients reacting only to rare beef may not need to maintain a complete beef elimination diet.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Animals
  • Asthma / complications
  • Cattle
  • Child
  • Child, Preschool
  • Dermatitis, Atopic / complications
  • Dietary Proteins / analysis*
  • Dietary Proteins / immunology*
  • Double-Blind Method
  • Electrophoresis, Polyacrylamide Gel
  • Enzyme-Linked Immunosorbent Assay
  • Food Handling / methods
  • Food Hypersensitivity / blood
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / immunology*
  • Humans
  • Immunoblotting
  • Immunoglobulin E / analysis
  • Immunoglobulin E / immunology
  • Immunoglobulin G / analysis
  • Infant
  • Meat / adverse effects*
  • Milk Hypersensitivity / complications*
  • Milk Hypersensitivity / immunology*
  • Rhinitis, Allergic, Perennial / complications
  • Rhinitis, Allergic, Seasonal / complications
  • Serum Albumin, Bovine / analysis
  • Skin Tests
  • Tissue Extracts / analysis
  • Tissue Extracts / immunology


  • Dietary Proteins
  • Immunoglobulin G
  • Tissue Extracts
  • Serum Albumin, Bovine
  • Immunoglobulin E