Utility of measuring tryptase levels in children and young adults

Ahmed, Fatimah; Fried, Ari J.; Spielman, Sara; Secor, W. Evan; MacGinnitie, Andrew J.

doi:10.1016/j.anai.2019.07.030

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Other studies have found tryptase ≥15 μg/L in 12% of patients with urticaria/ angioedema without anaphylaxis [25]. Hypertryptasemia was seen between 3 and 9% of patients with chronic spontaneous urticaria (CSU) [26,27]. As expected, this hypertryptasemic CSU cohort was older than the normotryptasemic CSU patients, and 44% consented to bone marrow biopsies which excluded systemic mastocytosis [27].…”

Section: Urticaria/angioedemasupporting

confidence: 58%

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

Lee

2020

Int Arch Allergy Immunol

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One of the most important blood tests in the field of allergy, mast cell tryptase has numerous diagnostic uses, particularly for anaphylactic reactions and for the diagnosis of mastocytosis. However, there are numerous other non-anaphylactic conditions where clinicians may see elevated serum tryptase (hypertryptasemia) and the practicing clinician ought to be aware of these important differential diagnoses. Such conditions include systemic mastocytosis, hematological malignancies, and chronic kidney disease. This article provides a comprehensive, updated summary on the variety of non-anaphylactic conditions where hypertryptasemia may be seen.

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Section: Urticaria/angioedemasupporting

confidence: 58%

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

Lee

2020

Int Arch Allergy Immunol

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“…Serum tryptase is the most specific marker of MC activation and is currently used as a reliable diagnostic tool for confirmation of MCDs, including MCAS, providing its correct measurement and interpretation (16). The serum tryptase level usually increases during mast cell degranulation, with a peak between 1 and 4 h. A normal tryptase level is considered 5 ng/ml, a level greater than 11.4 ng/ml is considered elevated and a level greater than 20 ng/ml is a minor diagnostic criterion for systemic mastocytosis (17). According to consensus criteria for MCAS diagnosis, a change of 20% of baseline serum tryptase level plus 2 ng/ml is indicative for a mast cell activation episode, mostly due to systemic immediate hypersensitivity reactions or anaphylaxis (12).…”

Section: Mast Cell Mediators and Their Clinical Use In Diagnosing Mcasmentioning

confidence: 99%

Mast cell activation syndromes ‑ evaluation of current diagnostic criteria and laboratory tools in clinical practice (Review)

et al. 2020

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Mast cell activation syndromes (MCAS) represent a heterogeneous clinical entity caused by episodic and severe mast cell activation, including primary and secondary mast cell disorders (MCDs). The group of primary or clonal MCDs refers to systemic mastocytosis, other clonal MCAS and hereditary hypertryptasemia, while the secondary MCAS is characterized by normal mast cells (MCs) which are activated by external triggers, such as allergens or physical stimuli. Another category of MCAS is the idiopathic form, when no trigger or genetic mutation can be identified. Symptoms of mast cell activation are due to release of specific mediators and can be seen in many diseases, such as allergies, with localized or systemic clinical manifestations. Confirmation of MCAS is based on diagnostic criteria proposed by an international group of experts and the best available evidence in this field. It is generally accepted that the clinical picture of MCAS is non-specific and there are few available laboratory tools, making it difficult for clinicians to identify and confirm this entity. The diagnosis is established after exclusion of other possible clinical entities in most of the cases. Therefore, the actual diagnostic criteria of MCASs, some relevant clinical aspects and laboratory tools used in clinical practice were reviewed.

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