Cited by 179Food Allergy and Anaphylaxis ResearchMast cells and histamineDrug-Induced Adverse Reactions

Usefulness and limitations of sequential serum tryptase for the diagnosis of anaphylaxis in 102 patients

Sala-Cunill, Anna, Cardona, Victoria, Labrador-Horrillo, Moises, Luengo, Olga, Esteso, Olga, Garriga, Teresa, Vicario, Maria, Guilarte, Mar·2013·International Archives of Allergy and Immunology

Abstract

BACKGROUND: The diagnosis of anaphylaxis is based on clinical history since no reliable biological marker is currently available to confirm the diagnosis. OBJECTIVE: It was the aim of this study to determine sequential serum tryptase concentrations during anaphylaxis and to evaluate its potential as a diagnostic marker. METHODS: We performed a prospective study including patients with acute anaphylaxis (according to the National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network criteria) attending the emergency department. Demographic characteristics, anaphylactic triggers, specific risk factors, clinical characteristics and management of anaphylaxis were recorded. Serum tryptase was measured at 1-2 h (T1), 4-6 h (T2) and 12-24 h (T3) following onset of the episode and at basal conditions (TB). RESULTS: A total of 102 patients were included (63 females, mean age 47.4 ± 19.1 years). Tryptase concentration at T1 (19.3 ± 15.4 µg/l) was significantly higher than at T2, T3 and TB (all <11.4 µg/l; p < 0.0001). Importantly, tryptase was not raised in 36.3% of cases; furthermore, in 60.6% of these patients, no changes were observed in tryptase levels comparing T1 and TB (ΔT1-TB = 0). Tryptase was more frequently elevated in more severe anaphylaxis (p < 0.0001) and positively correlated with the grades of severity (p < 0.001, r = 0.49). Anaphylaxis was more severe and tryptase concentration higher when the causative agent was a drug compared to food, both at T1 (p = 0.045) and at TB (p = 0.019). Age and coronary risk factors were associated with more severe anaphylaxis (p = 0.001). CONCLUSION: Tryptase is a biomarker related to the severity of anaphylaxis. However, since its concentration remains unaltered in a considerable number of patients during acute anaphylaxis, there is a need for more reliable diagnostic biological tests.

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Crossref · 10.1159/000339749

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  • Generally, the severity and magnitude of hypotension in anaphylaxis correlate with the height of tryptase.

    “Generally, the severity and magnitude of hypotension in anaphylaxis correlate with the height of tryptase [29,30].”

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Authors
Sala-Cunill, A., Cardona, V., Labrador-Horrillo, M., Luengo, O., Esteso, O., Garriga, T., Vicario, M., & Guilarte, M.
Affiliations
  • Universitat Autònoma de Barcelona (ES)
  • Vall d'Hebron Hospital Universitari (ES)
Venue
International Archives of Allergy and Immunology
Publisher
S. Karger AG
Published
2012-09-25
Volume
160
Issue
2
Pages
192-199
ISSN
  • 1018-2438 (ISSN-L)
  • 1423-0097
OpenAlex
W2001266300
Cited by
179
References
32
Citations by year
2026: 7 · 2025: 9 · 2024: 11 · 2023: 15 · 2022: 20 · 2021: 14 · 2020: 14 · 2019: 11 · 2018: 13 · 2017: 14 · 2016: 10 · 2015: 16 · 2014: 16 · 2013: 8 · 2012: 1
FWCI
9.65
Type
journal article
Language
en
Open access
closed
Locations
  • International Archives of Allergy and Immunology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
  • Life Sciences › Immunology and Microbiology › Immunology › Mast cells and histamine
  • Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
Keywords
anaphylaxis, serum tryptase, diagnostic biomarkers, anaphylaxis severity, drug-induced anaphylaxis, food-induced anaphylaxis, emergency department
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Anaphylaxis, Female, Humans, Male, Middle Aged, Biomarkers, Tryptases, Young Adult

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