Serum Tryptase Levels in 114 Pediatric Patients with Cutaneous Mastocytosis

Abstract

Increasing rates of food allergy are linked to higher socioeconomic status, but the relationship between socioeconomic status and hospitalization for food-induced anaphylaxis (FIA) is not clear. We sought to identify socioeconomic factors related to hospitalization for FIA. METHODS: We utilized the Healthcare Cost and Utilization Project database from 2005 through 2012 to identify hospitalizations due to FIA. Cases were stratified by race (Caucasian, African American(AA), Hispanic, Asian/Pacific American(A/P), Native American(NA), Other), median household income national quartile for patient zip code, and primary payer (Medicaid, Medicare, Private, Self-pay, Other). Data were analyzed via Pearson's chi-squared statistical analysis. RESULTS: We identified 12597 hospitalizations due to FIA. Overall, 51% of FIA cases were identified as Caucasian, 22% AA, 14% Hispanic, 6% A/ P, and 1% NA. Twenty five percent of FIA cases occurred within the lowest income quartile. Of these, 28% identified as Caucasian, 40% AA, 20% Hisp, 3.6% A/P and 2% NA. Cases in the lowest income quartile accounted for 14% of all FIA among Caucasians, 49% among AA, 40% among Hispanics, and 50% among NA. In this quartile, 43% of AA and 51% of Hispanics reported Medicaid as primary payer, compared with 16% of Caucasians. P<0.001 for all comparisons. CONCLUSIONS: Hospitalizations for FIA occurs disproportionately in AA, Hispanic, and NA patients in the lowest income quartile and with Medicaid coverage, suggesting socioeconomic factors contribute to this risk. Targeted preventive measures such as improved subspecialty care, avoidance support, and active education/counseling about FIA may benefit these populations.

Molecular Background, Clinical Features and Management of Pediatric Mastocytosis: Status 2021

“…It was shown that children with elevated serum tryptase level, but no organomegaly, did not fulfil SM criteria [ 9 ]. Furthermore, it was reported that increased serum tryptase levels in small children are commonly related to extensive skin involvement (particularly in children with DCM) without underlying SM [ 7 , 94 , 109 , 133 ]. In children with CM, serum tryptase levels usually decrease over time and correlate with the improvement of clinical symptoms [ 9 , 91 , 94 , 109 ].…”

Drugs and Vaccines Hypersensitivity in Children with Mastocytosis

“…On the other hand, in cases of systemic symptoms elevated tryptase levels are not always detected. In a retrospective study, tryptase higher than 10 ng/mL was detected in less than 1/4 of 114 children with cutaneous mastocytosis and systemic symptoms [ 32 ]. In cases of severe anaphylaxis clonal MC disorders should be excluded.…”

Elevated Serum Tryptase in Non-Anaphylaxis Cases: A Concise Review

“…Patients with systemic mastocytosis tend to have higher total serum tryptase than those with cutaneous mastocytosis [16]. Furthermore, within the latter group, those with more extensive disease (diffuse cutaneous mastocytosis), have higher tryptase levels than more limited disease (mastocytoma, maculopapular cutaneous mastocytosis) [17,18]. Children with cutaneous mastocytosis were more likely to have flushing symptoms and bullous skin lesions with hypertryptasemia [19].…”