Disease Spectrum of Anaphylaxis Disorders
Abstract
Anaphylaxis results from massive mast cell activation. Mechanisms of mast cell activation may involve IgE- and non-IgE-mediated triggers, clonal mast cell disease, or be idiopathic and may be modified by several factors including but not restricted to hormonal status, stress, heritable factors, mast cell burden, and simultaneous exposure to more than 1 factor. Patients with recurrent anaphylaxis with a nonidentifiable trigger present a particular challenge in diagnosis and management. Presence of clonal disease may be suggested by hypotensive episodes with urticaria and angioedema, and high baseline tryptase levels. A number of scoring systems have been developed to identify patients who are at high risk to have underlying mastocytosis. This review provides an overview of anaphylaxis disorders and our current understanding of their mechanisms of action, evaluation, and management.
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Regarding baseline serum tryptase, the REMA score includes < 15 (−1 point) and > 25 ng/mL (+2 points); Karolinska uses < 11.4 ng/mL (−1 point) and >20 ng/mL (+2 points); NICAS uses only 11.4 ng/mL as cut off.
“Regarding bST, the REMA score includes < 15 (−1 point) and > 25 ng/mL (+2 points); while Karolinska uses < 11.4 ng/mL (−1 point) and >20 ng/mL (+2 points), and finally, NICAS uses only 11.4 ng/mL as cut off [60].”
From Diagnostic Significance of Tryptase for Suspected Mast Cell Disorders (2023) · cites this paper as [60]
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Diagnostic Significance of Tryptase for Suspected Mast Cell Disorders
Beyens, M., Toscano, A., Ebo, D., Gülen, T., & Sabato, V. (2023) · Diagnostics · doi:10.3390/diagnostics13243662 · Cited by 22 · see citing works
- Authors
- González de Olano, D., Cain, W. V., Bernstein, J. A., & Akin, C.
- Affiliations
- University of Cincinnati (US)
- University of Michigan (US)
- Corresponding author
- Akin, Cem
- Venue
- The Journal of Allergy and Clinical Immunology In Practice
- Publisher
- Elsevier BV
- Published
- 2023-07
- Volume
- 11
- Issue
- 7
- Pages
- 1989-1996
- ISSN
- 2213-2198 (ISSN-L)
- OpenAlex
- W4377195426
- Cited by
- 19
- References
- 68
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 6 · 2023: 2
- FWCI
- 0.53
- Type
- journal article
- Language
- en
- Update notices
- erratum (2023-09-01)
- Open access
- closed
- Locations
- The Journal of Allergy and Clinical Immunology In Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Mast cells and histamine
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
- Keywords
- anaphylaxis, mast cell activation, mast cell disease, mastocytosis, idiopathic anaphylaxis, recurrent anaphylaxis, tryptase, IgE-mediated hypersensitivity, angioedema, urticaria, risk scoring, anaphylaxis management
- MeSH terms
- Anaphylaxis, Humans, Hypotension, Mast Cells, Mastocytosis, Urticaria, Tryptases
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